111-24 Exhibit A.pdf

THIS FORM MUST BE SUBMITTED BY THE BIDDER (Enclose original bid and one copy, copy must be supplied on an external hard drive) 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. Nationwide Cleaning & Restoration Services Print Name of Business: Name of Contact Person: Salvador Carmelino Print Correspondence Address (including zip code): 101 Hudson st, 21st Fl, Jersey City, NJ 07302 Purchase Order Address (including zip code): 101 Hudson st , 21st Fl, Jersey City, NJ 07302 Payment Address (including zip code): 101 Hudson st , 21st Fl, Jersey City, NJ 07302 Telephone Number: 929.332.5211 929.389.1957 Fax Number: E-mail Address SCarmelino@nationwiderestore.com Employer. ss. |