104-24 Exhibits-Economic Development Counsultant - 2024.pdf

VENDOR INFORMATION In order to assure that all future correspondence is directed to the correct address, assure proper ordering, expedite future payments, and in accord with I.R.S. regulations, the following information must be provided with this bid. Nishuane Group, LLC Name of Business: ___________________________________________________________ Print Michele S. Delisfort Name of Contact Person: ______________________________________________________ Print Correspondence Address (including zip code): 105 Grove Street, Suite 3, Montclair, NJ 07042 _____________________________________ _____________________________________ _____________________________________ Purchase Order Address (including zip code): 105 Grove Street, Suite 3, Montclair, NJ 07042 _____________________________________ _____________________________________ _____________________________________ Payment Address (including zip code): 105 Grove Street, Suite 3, Montclair, NJ 07042 _____________________________________ _____________________________________ _____________________________________ 973-954-2677 Telephone Number: ___________________________ N/A Fax Number: _________________________________ MDelisfort@nishuanegroup.com E-mail Address _______________________________ 74-3234172 Employer I.D. or S.S. # _________________________ *PLEASE ALSO PROVIDE A COPY OF YOUR W-9 30