Account Name

Mailing Address

Street Address City State / Province / Region ZIP / Postal Code Country

Is Billing Address the Same as Mailing Address?

Yes

Billing Address

Street Address City State / Province / Region ZIP / Postal Code Country

Phone Number

Fax Number

Accounts Payable Contact

E-Mail Address

Type of Business

Corporation

Partnership

Proprietorship

LLC

Limited Partnership

Business Category

(i.e. Painter, Builder, Cabinet Shop, etc…)

Estimated Monthly Purchase

# Employees

Tax Exempt

Yes

If yes – please attach certificate with application

Please Attach Tax Exempt Certificate with Application

Max. file size: 128 MB.

Year Established

Social Security Number

Federal Tax ID Number

Date of Birth

TRADE REFERENCES

Name

Account Number

Phone Number

Printed Name

Signature(Required)

Address

Street Address City State / Province / Region ZIP / Postal Code

Date

TERMS AND CONDITIONS

FINANCE CHARGES

Applicant will receive a monthly statement. When payment is required under the terms of any statement sent to Applicant, Applicant must pay the entire amount by the 30th day of each month. If the balance shown on the monthly statement is not paid before the 30th day of the same month, interest will accrue on that unpaid amount at the highest rate allowable by Florida Law.

LIMITED WARRANTY

Duval Paint & Decorating, Inc. gives a limited manufacturer’s warranty on all products it manufactures for a period of two (2) months. If there are any manufacturer’s defects in the products, Duval Paint & Decorating, Inc. reserves the right to repair or replace the product within the warranty period. Duval Paint & Decorating, Inc. gives no warranty against latent or patent defects in material, workmanship, capacity or operating capacity of any materials after the warranty period. Other than the express limited warranty as above provided, there are no other warranties, express or implied including the implied warranties of merchantability and fitness for a particular purpose.

ACCEPTANCE OF MATERIALS

The failure of Applicant to object in writing to the condition of any product sold by Duval Paint & Decorating, Inc. within 48 hours of delivery will constitute an acknowledgment that the goods have been accepted and found in good, safe and merchantable condition, fit for Applicant’s intended use.

NON LIABILITY OF DUVAL PAINT & DECORATING, INC.

Regardless of whether a claim against sounds in contract, tort or otherwise, Duval Paint & Decorating, Inc. will not be liable to Applicant for any loss, delay or damage of any kind or character resulting from accidental breakage, defects in or inefficiency of any equipment from the failure to properly perform services or from any other cause whatsoever; Duval Paint & Decorating, Inc. will not be liable for any incidental or consequential damage. Duval Paint & Decorating, Inc. will not be liable for the inability of the Applicant to use the product for any purpose.

TAXES

Applicant will pay all sales and use taxes, all personal property taxes and all other taxes whatsoever.

INDEMNIFICATION

Applicant will indemnify and hold Duval Paint & Decorating, Inc. harmless from any liability of any kind, including reasonable attorney’s fees.

ATTORNEY’S FEES

If Duval Paint & Decorating, Inc. employs an attorney to enforce any provision of this application or invoice, or to defend any action brought by Applicant, its agents or employees against Duval Paint & Decorating Inc., whether the action sounds in contract, in tort or otherwise, or to collect any payment due to Duval Paint & Decorating, Inc., from Applicant, whether or not suit is instituted, Duval Paint & Decorating, Inc. will be entitled to recover from Applicant all costs and expenses incurred including a reasonable attorney’s fee.

VENUE/JURY TRIAL/INTEREST

Applicant will pay interest on all monies due to Duval Paint & Decorating, Inc. at the highest lawful contract rate. Applicant waives any right to jury trial in any action brought by or against Applicant involving Duval Paint & Decorating, Inc., regardless of whether the claim sounds in contract, in tort or otherwise, or is in any proceeding related, ancillary or supplementary to this application. Applicant waives any right of venue and agrees that any legal action or arbitration proceeding between Applicant and Duval Paint & Decorating, Inc. regardless of whether it sounds in contract, in tort or otherwise, will be brought in a state court or competent jurisdiction located in Duval County, Florida.

PERSONAL GUARANTY

The person signing this application on behalf of the Applicant, personally and individually, guarantees the full and prompt performance of the Applicant and the payment of all sums due to Duval Paint & Decorating, Inc. As used in this Application, the term “Applicant” will also include the guarantor and any other party to this Application and all waivers are equally applicable to those persons.

Initials

Credit Application