GMC Account Application – Fillable Form

The information provided by the applicant ("Buyer") in this Account Application and Master Purchase Agreement ("Agreement") is for the purposes of establishing a commercial credit account with Golden Mattress Co., Inc. ("Seller").

Buyer's Information

Legal Business Name *

DBA or Assumed Names

Street Address *

City *

State *

ZIP *

Phone No *

Fax

Email Address *

State of Incorporation

Date of Incorporation

Business Structure

Responsible Parties

Names of all owners/partners

Bank Information

Bank(s) on which checks will be drawn on

Bank 1 Name

Bank 1 Account No.

Bank 2 Name

Bank 2 Account No.

Bank Contact Name & Number

Authorized Persons on Account

All persons authorized to purchase

All persons authorized to sign checks

Trade References

List two trade references transacted within the previous 12 months.

Reference 1

Name

Address

City

State

ZIP

Phone

Fax

Reference 2

Name

Address

City

State

ZIP

Phone

Fax

Terms and Conditions

1. Governing Terms. The terms and conditions of this Agreement shall govern all sales by Seller to Buyer. No terms or conditions contained in Buyer's purchase order or other document that add to, modify or conflict with the terms and conditions of this Agreement shall be binding upon Seller unless specifically accepted in writing by an authorized representative of Seller.

2. Payment. All invoices are due and payable within thirty (30) days of date of invoice. Past-due invoices shall bear interest at the rate of eighteen percent (18%) per annum or the maximum rate allowed by applicable law, whichever is less, from the date due until paid in full.

3. Returned Checks. A $15.00 handling fee will be assessed for each check returned for insufficient funds or any other reason.

4. References. Buyer hereby authorizes Seller to make such credit investigations as Seller deems necessary, including contacting bank and trade references provided herein and obtaining consumer credit reports on any individual guarantor(s).

5. Buyer's Duty to Inspect Deliveries. Buyer shall inspect all goods upon delivery. Buyer must report to Seller any shortage, damage, or nonconformity within forty-eight (48) hours of delivery. Failure to report within this period shall constitute acceptance of the goods as delivered.

6. Limitation of Liability. Seller's total liability under this Agreement shall not exceed the purchase price of the goods giving rise to such liability. In no event shall Seller be liable for any indirect, incidental, special, consequential, or punitive damages.

7. Limited Warranty. Seller warrants to the first retail customer that its products will be free from defects in materials and workmanship for a period of one (1) year from the date of original retail purchase. This warranty is non-transferable and applies only to the original retail purchaser.

8. No Other Warranties. EXCEPT AS EXPRESSLY SET FORTH HEREIN, SELLER MAKES NO WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

9. Collection Costs. In the event Seller retains an attorney or collection agency to collect amounts owed by Buyer, Buyer agrees to pay all reasonable attorney's fees, collection agency fees, court costs, and other expenses of collection.

10. Governing Law and Venue. This Agreement shall be governed by and construed in accordance with the laws of the State of Texas. Any suit, action, or proceeding arising out of this Agreement shall be brought exclusively in the state or federal courts located in Dallas County, Texas.

11. Indemnification. Buyer agrees to indemnify, defend, and hold harmless Seller and its officers, directors, employees, and agents from any and all claims, damages, losses, and expenses (including reasonable attorney's fees) arising out of or related to Buyer's use or resale of the goods.

12. Personal Guaranty. If required by Seller, the individual(s) signing below as Guarantor(s) personally and unconditionally guarantee the full and prompt payment and performance of all obligations of Buyer to Seller under this Agreement.

13. Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, representations, warranties, commitments, offers, and agreements, written or oral.

I have read and agree to the Terms and Conditions of Sale above. *

Signatures

Buyer

Signature *

Draw your signature above using your mouse or finger.

By (Printed Name) *

Title *

Date *

Golden Mattress Co., Inc. — Seller

X ________________

By:

Title:

Date:

Guarantor(s)

For value received and to induce Seller to extend credit to Buyer, the undersigned unconditionally guarantee all obligations owed by Buyer to Seller.

Guarantor 1

Signature *

Draw your signature above using your mouse or finger.

Printed Name *

Date *

Guarantor 2 (optional)

Signature (optional)

Draw your signature above using your mouse or finger.

Printed Name

Date

Form 01-339 (Rev. 4-13/8) — This certificate should be furnished to the supplier. Do not send the completed certificate to the Comptroller of Public Accounts.

Purchaser Information

Name of Purchaser, Firm or Agency *

Phone (Area code and number) *

Address (Street & number, P.O. Box or Route number) *

City *

State *

ZIP *

Texas Sales and Use Tax Permit Number *

Must contain 11 digits

Out-of-state retailer's registration number or RFC number (Mexico)

Seller Information

Seller Name

Golden Pedic Inc. DBA Golden Mattress Co., Inc.

Street Address

1240 Titan Drive

City

Dallas

State

ZIP

75247

Purchase Details

Description of Items to be Purchased on the Attached Order or Invoice

Mattresses and/or foundations

Description of the type of business activity generally engaged in or type of items normally sold by the purchaser

Certificate Statement

The taxable items described above, or on the attached order or invoice, will be resold, rented or leased by me within the geographical limits of the United States of America, its territories and possessions or within the geographical limits of the United Mexican States, in their present form or attached to other taxable items to be sold.

I understand that if I make any use of the items other than retention, demonstration or display while holding them for sale, lease or rental, I must pay sales tax on the items at the time of use based upon either the purchase price or the fair market rental value for the period of time used.

I understand that it is a criminal offense to give a resale certificate to the seller for taxable items that I know, at the time of purchase, are purchased for use rather than for the purpose of resale, lease or rental, and depending on the amount of tax evaded, the offense may range from a Class C misdemeanor to a felony of the second degree.

I certify the above statements are true and correct. *

Document Upload

Attach Supporting Document *

📎

Drag & drop your file here, or browse

Accepted formats: PDF, JPG, JPEG · Max size: 10 MB

Purchaser Signature

Purchaser Signature *

Draw your signature above using your mouse or finger.

Title *

Date *