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Basanite, Inc. – ‘10-K’ for 12/31/17 – ‘EX-10.23’

On:  Tuesday, 7/17/18, at 5:31pm ET   ·   For:  12/31/17   ·   Accession #:  1553350-18-813   ·   File #:  0-53574

Previous ‘10-K’:  ‘10-K’ on 4/26/17 for 12/31/16   ·   Next:  ‘10-K’ on 3/28/19 for 12/31/18   ·   Latest:  ‘10-K/A’ on 5/10/24 for 12/31/23   ·   1 Reference:  By:  Basanite, Inc. – ‘10-K’ on 3/31/21 for 12/31/20

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 7/17/18  Basanite, Inc.                    10-K       12/31/17   80:9.8M                                   Edgar Filing LLC/FA

Annual Report   —   Form 10-K   —   Sect. 13 / 15(d) – SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 10-K        Annual Report                                       HTML    772K 
 2: EX-10.16    Operating Agreement                                 HTML    110K 
 3: EX-10.18    Letter of Resignation                               HTML     22K 
 4: EX-10.19    Membership Interest Purchase Agreement              HTML     64K 
 5: EX-10.20    Extension to Unsecured Promissory Note              HTML     21K 
 6: EX-10.23    Form of Note Payable                                HTML     49K 
 7: EX-10.24    Promissory Note                                     HTML     21K 
 8: EX-10.25    Secured Promissory Note and General Collateral      HTML     57K 
                Assignment and Security Agreement                                
 9: EX-10.26    Non-Interest Bearing Demand Note                    HTML     27K 
10: EX-10.27    Non-Interest Bearing Demand Note                    HTML     27K 
11: EX-21.1     Subsidiaries List                                   HTML     21K 
12: EX-31.1     Certification -- §302 - SOA'02                      HTML     27K 
13: EX-31.2     Certification -- §302 - SOA'02                      HTML     27K 
14: EX-32.1     Certification -- §906 - SOA'02                      HTML     24K 
21: R1          Document and Entity Information                     HTML     50K 
22: R2          Consolidated Balance Sheets                         HTML    123K 
23: R3          Consolidated Balance Sheets (Parenthetical)         HTML     41K 
24: R4          Consolidated Statements of Operations               HTML     90K 
25: R5          Consolidated Statement of Stockholders' Equity      HTML     83K 
                (Deficit)                                                        
26: R6          Consolidated Statement of Cash Flows                HTML    120K 
27: R7          Consolidated Statement of Cash Flows                HTML     95K 
                (Parenthetical)                                                  
28: R8          Organization, Nature of Business and Going Concern  HTML     37K 
29: R9          Summary of Significant Accounting Policies          HTML     88K 
30: R10         Recent Accounting Pronouncements                    HTML     32K 
31: R11         Acquisition of Basalt America                       HTML    106K 
32: R12         Discontinued Operations                             HTML     51K 
33: R13         Notes Payable Related Party - Convertible           HTML     51K 
34: R14         Note Payable - Convertible                          HTML     30K 
35: R15         Notes Payable                                       HTML     27K 
36: R16         Notes Payable - Related Party                       HTML     27K 
37: R17         Purchase Order Financing                            HTML     28K 
38: R18         Purchase Order Financing - Related Party            HTML     26K 
39: R19         Commitments and Contingencies                       HTML     60K 
40: R20         Stockholders' Equity (Deficit)                      HTML     63K 
41: R21         Options and Warrants                                HTML     61K 
42: R22         Related Parties                                     HTML     28K 
43: R23         Concentrations                                      HTML     25K 
44: R24         Subsequent Events                                   HTML     48K 
45: R25         Summary of Significant Accounting Policies          HTML    142K 
                (Policies)                                                       
46: R26         Summary of Significant Accounting Policies          HTML     68K 
                (Tables)                                                         
47: R27         Acquisition of Basalt America (Tables)              HTML    104K 
48: R28         Discontinued Operations (Tables)                    HTML     56K 
49: R29         Notes Payable Related Party - Convertible (Tables)  HTML     50K 
50: R30         Commitments and Contingencies (Tables)              HTML     39K 
51: R31         Options and Warrants (Tables)                       HTML     52K 
52: R32         Organization, Nature of Business and Going Concern  HTML     50K 
                (Details)                                                        
53: R33         Summary of Significant Accounting Policies          HTML    101K 
                (Computer and Equipment and Website Costs)                       
                (Details)                                                        
54: R34         Summary of Significant Accounting Policies          HTML     33K 
                (Schedule of Dilutive Shares Not Included in Loss                
                Per Share Computation) (Details)                                 
55: R35         Summary of Significant Accounting Policies (Income  HTML     47K 
                Taxes Narrative) (Details)                                       
56: R36         Summary of Significant Accounting Policies (Income  HTML     46K 
                Taxes) (Details)                                                 
57: R37         Acquisition of Basalt America (Narrative)           HTML     30K 
                (Details)                                                        
58: R38         Acquisition of Basalt America (Consolidated         HTML    165K 
                Balance Sheet with Retrospective Adjustments)                    
                (Details)                                                        
59: R39         Discontinued Operations (Schedule of Discontinued   HTML     51K 
                Operations) (Details))                                           
60: R40         Discontinued Operations (Schedule of Balance        HTML     30K 
                Sheets from Discontinued Operations (held For                    
                Sale)) (Details))                                                
61: R41         Notes Payable Related Party - Convertible           HTML     89K 
                (Narrative) (Details)                                            
62: R42         Notes Payable Related Party - Convertible           HTML     55K 
                (Schedule of Convertible Notes Payable) (Details)                
63: R43         Note Payable - Convertible (Details)                HTML     67K 
64: R44         Notes Payable (Details)                             HTML     56K 
65: R45         Notes Payable - Related Party (Details)             HTML     40K 
66: R46         Purchase Order Financing (Details)                  HTML     55K 
67: R47         Purchase Order Financing Related Party (Details)    HTML     35K 
68: R48         Commitments and Contingencies (Narrative)           HTML    137K 
                (Details)                                                        
69: R49         Commitments and Contingencies (Schedule of Future   HTML     33K 
                Minimum Rental Payments) (Details)                               
70: R50         Commitments and Contingencies (Schedule of Sales    HTML     31K 
                Commission Percentages) (Details)                                
71: R51         Commitments and Contingencies (Schedule of          HTML     37K 
                Remaining Obligations from Business Acquisition)                 
                (Details)                                                        
72: R52         Stockholders Deficit (Details)                      HTML    670K 
73: R53         Options and Warrants (Narrative) (Details)          HTML    142K 
74: R54         Options and Warrants (Summary of Options and        HTML     63K 
                Warrants Activity) (Details)                                     
75: R55         Related Parties (Details)                           HTML     65K 
76: R56         Concentrations (Details)                            HTML     28K 
77: R57         Subsequent Events (Details)                         HTML    274K 
79: XML         IDEA XML File -- Filing Summary                      XML    130K 
78: EXCEL       IDEA Workbook of Financial Reports                  XLSX     95K 
15: EX-101.INS  XBRL Instance -- paym-20171231                       XML   2.15M 
17: EX-101.CAL  XBRL Calculations -- paym-20171231_cal               XML    198K 
18: EX-101.DEF  XBRL Definitions -- paym-20171231_def                XML    836K 
19: EX-101.LAB  XBRL Labels -- paym-20171231_lab                     XML   1.39M 
20: EX-101.PRE  XBRL Presentations -- paym-20171231_pre              XML   1.03M 
16: EX-101.SCH  XBRL Schema -- paym-20171231                         XSD    253K 
80: ZIP         XBRL Zipped Folder -- 0001553350-18-000813-xbrl      Zip    181K 


‘EX-10.23’   —   Form of Note Payable


This Exhibit is an HTML Document rendered as filed.  [ Alternative Formats ]



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  FORM OF CONVERTIBLE PROMISSORY NOTE  
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EXHIBIT 10.23

ANY SHARES ACQUIRED UPON CONVERSION OF THIS NOTE OR ANY PORTION THEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, (THE “ACT”) OR ANY STATE SECURITIES LAWS, AND MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED, HYPOTHECATED, OR OTHERWISE TRANSFERRED IN THE ABSENCE OF (A) AN EFFECTIVE REGISTRATION STATEMENT UNDER THE ACT AND ANY APPLICABLE STATE SECURITIES LAWS, OR (B) AN OPINION OF COUNSEL ACCETABLE TO COUNSEL FOR THE ISSUER THAT SUCH REGISTRATION IS NOT REQUIRED AND THAT THE PROPOSED TRANSFER MAY BE MADE WITHOUT VIOLATION OF THE ACT AND ANY APPLICABLE STATE SECURITIES LAW.

No. PAYMEON _________


$_________________

Note Date: _______________


PAYMEON, INC.
(a Nevada corporation)

7% CONVERTIBLE PROMISSORY NOTE
Due On or Before ___________

PAYMEON, INC., a Nevada corporation (the “Company”), for value received and intending to be legally bound, hereby promises to pay to the order of _________________ (“Holder”), the principal amount of ___________________ Dollars (the “Principal Amount”) on or before Mmmm DD, YYYY (the “Maturity Date”), together with interest thereon at the rate of 7% per annum (the “Interest”), as set forth herein (the “Note”).

1.

Convertible Note:  By accepting this Note, the Holder hereby acknowledges that this Note has not been registered under the Securities Act of 1933, as amended, or any state securities laws and Holder represents for himself and his legal representative that he is acquiring this Note and will acquire any shares issued upon conversion hereof, for his own account, for investment purposes only and not with a view to, or for sale in connection with, any distribution of such securities and Holder agrees to reaffirm, in writing, this investment representation at the time of exercise of the conversion right set forth herein.

2.

Principal and Interest Payment:  The Company shall pay (or cause to be paid) interest to the Holder on the aggregate unconverted and then outstanding principal amount of this Note at the rate of 7% per annum, accrued monthly and payable on the Maturity Date of ___________, unless the Note is converted or prepaid prior to the Maturity Date, in which case all accrued interest through the conversion or prepayment date shall become payable.

3.

Interest Rate Protection:  Should the Company issue any new or additional promissory notes that pay an interest rate that exceeds 7% per annum, then Holder shall be entitled to request an increase in the Interest rate payable on this Note to an amount equal to the rate being paid on the new or additional notes.  Any increase in the Interest rate shall be payable from the date of the increase forward and shall not be applied in arrears.




 


4.

Unsecured Obligation:  The obligations of the Company under this Note are unsecured.

5.

Conversion of Note:  This Note may be converted into shares of Common Stock of the Company (the “Common Stock”), at any time, at the option of the Holder as follows:

(a)

Conversion:  Subject to and upon compliance with the provision of this Section 4, at the option of the Holder, at any time on or before the Maturity Date the unpaid principal and interest balance of the Note may be converted in whole or in part, into fully-paid and non-assessable shares of Common Stock, par value $0.001 per share, of the Company (the “Shares”) at the conversion rate equal to $_______ per share, except as otherwise adjusted below (the “Conversion Price”). The conversion date shall be the date that such Notice of Conversion is deemed delivered hereunder. Upon conversion of the entire principal balance, the principal represented thereby shall be canceled. Such conversion shall be effectuated by the Holder submitting to the Company a notice of conversion attached hereto as Exhibit “1” (the “Conversion Notice”). The Conversion Notice shall state the dollar amount thereof to be so converted and shall include or be accompanied by representations as to the Holder’s investment intent substantially similar to those contained in this Note. Shares issuable upon conversion of the Note shall be issued in the name of the Holder and shall be transferrable only in accordance with all of the terms and restrictions contained herein.

(b)

Fractional Shares:   No fractional shares or scrip representing fractional shares shall be issued upon the conversion of this Note. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such conversion, the Company shall at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such fraction multiplied by the Conversion Price or round up to the next whole share.

(c)

Holder’s Conversion Limitations:  The Company shall not effect any conversion of this Note, and Holder shall not have the right to convert any portion of this Note, to the extent that after giving effect to the conversion set forth on the applicable Notice of Conversion, the Holder (together with the Holder’s Affiliates, and any persons acting as a group together with the Holder or any of the Holder’s Affiliates) would beneficially own in excess of the Beneficial Ownership Limitation (as defined below). For purposes of the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates shall include the number of shares of Common Stock issuable upon conversion of this Note with respect to which such determination is being made, but shall exclude the number of shares of Common Stock which are issuable upon (i) conversion of the remaining, unconverted principal amount of this Note beneficially owned by the Holder or any of its Affiliates and (ii) exercise or conversion of the unexercised or unconverted portion of any other securities of the Company subject to a limitation on conversion or exercise analogous to the limitation contained herein beneficially owned by the Holder or any of its affiliates. Except as set forth in the preceding sentence, for purposes of this Section 4(c), beneficial ownership shall be calculated in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and the rules and regulations promulgated thereunder. To the extent that the limitation contained in this Section 4(c) applies, the determination of whether this Note is convertible (in relation to other securities owned by the Holder together with any Affiliates) and of which principal amount of this Note is convertible shall be in the sole discretion of the Holder, and the submission of




 


a Notice of Conversion shall be deemed to be the Holder’s determination of whether this Note may be converted (in relation to other securities owned by the Holder together with any affiliates) and which principal amount of this Note is convertible, in each case subject to the Beneficial Ownership Limitation. To ensure compliance with this restriction, the Holder will be deemed to represent to the Company each time it delivers a Notice of Conversion that such Notice of Conversion has not violated the restrictions set forth in this paragraph and the Company shall have no obligation to verify or confirm the accuracy of such above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated thereunder. For purposes of this Section 4(c), in determining the number of outstanding shares of Common Stock, the Holder may rely on the number of outstanding shares of Common Stock as stated in the most recent of the following: (i) the Company’s most recent periodic or annual report filed with the Commission, as the case may be, (ii) a more recent public announcement by the Company, or (iii) a more recent written notice by the Company or the Company’s transfer agent setting forth the number of shares of Common Stock outstanding. Upon the written request of Holder, the Company shall within two trading days confirm orally and in writing to the Holder the number of shares of Common Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the conversion or exercise of securities of the Company, including this Note, by the Holder or its Affiliates since the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership Limitation” shall be 4.99% of the number of shares of the Common Stock outstanding immediately after giving effect to the issuance of shares of Common Stock issuable upon conversion of this Note held by the Holder. The Holder, upon not less than 61 days’ prior notice to the Company, may increase or decrease the Beneficial Ownership Limitation provisions of this Section 4(c). Any such increase or decrease will not be effective until the 61st day after such notice is delivered to the Company. The Beneficial Ownership Limitation provisions of this paragraph shall be construed and implemented in a manner otherwise than in strict conformity with the terms of this Section 4(c) to correct this paragraph (or any portion hereof) which may be defective or inconsistent with the intended Beneficial Ownership Limitation contained herein or to make changes or supplements necessary or desirable to properly give effect to such limitation. The limitations contained in this paragraph shall apply to a successor holder of this Note. For purposes of this Section “Affiliate” means any person that, directly or indirectly through one or more intermediaries, controls or is controlled by or is under common control with a person, as such terms are used in and construed under Rule 405 under the Securities Act of 1933, as amended (the “Act”).

(d)

Subdivision or Combination:  Whenever the Company shall subdivide or combine the outstanding shares of Common Stock issuable upon conversion of this Note, the Conversion Price in effect immediately prior to such subdivision or combination shall be proportionately decreased in the case of subdivision or increased in the case of combination effective at the time of such subdivision or combination.

(e)

Reclassification or Change:  Whenever any reclassification or change of the outstanding shares of Common Stock shall occur (other than a change in par value, or from par value to no par, or from no par to par value, or as a result of a subdivision or combination), effective provision shall be made whereby the Holder shall have the right, at any time thereafter, to receive upon conversion of the Note the kind of stock, other securities or property receivable upon such reclassification by a holder of the number of share of Common Stock issuable upon conversion of this Note immediately prior to such




 


reclassification. Thereafter, the rights of the parties hereto with respect to the adjustments of the amount of securities or other property obtainable upon conversion of this Note shall be appropriately continued and preserved, so as to afford as nearly as may be possible protection of the nature afforded by this subparagraph (e).

(f)

Merger:  If, prior to repayment of the obligations relevant hereto, or prior to conversion of this Note into equity in the Company, the Company shall be consolidated or merged with another company, or substantially all of its assets shall be sold to another company in exchange for stock wit the view to distributing such stock to its shareholders, each share of stock into which this Note is convertible shall be replaced for the purposes hereof by a pro rata amount of the securities or property issuable or distributable, based upon percentage of the Company’s common stock which a Holder would have owned had there been a conversion herein after consummation of such merger, consolidation or sale and adequate provision to that effect shall be made at the time thereof. The Company will provide the Holder at least thirty (30) days prior written notice of any event described in this subsection (f).

6.

Company Right to Require Conversion:  After 180 days from the date of issuance of this Note, the Company shall have the right to require Holder to convert all or any part of the Note if the closing share price of Paymeon common stock as quoted on any public exchange or quotation system shall be equal to or greater than $0.70 per share for 20 consecutive trading days, such consecutive trading days being exclusive of the first 180 days post issuance of this Note.

7.

Reservation of Common Shares:  The Company shall take or has taken all steps necessary to reserve a number of its authorized but unissued Common Stock sufficient for issuance upon conversion of this Note pursuant to the provisions included hereinabove.

8.

Securities Laws and Restrictions:  This Note and the Common shares issuable upon conversion have not been registered for sale under the Act, and neither this Note nor those shares nor any interest in this Note nor those shares may be sold, offered for sale, pledged or otherwise disposed of without compliance with applicable securities laws, including, without limitation, an effective registration statement relating thereto or delivery of an opinion of counsel acceptable to the Company that such registration is not required under the Act. Holder has reviewed the Company’s periodic and annual reports as filed with the Securities and Exchange Commission (the “SEC Reports”) and has based its investment decision solely on the information contained in the SEC Reports.  Holder represents and warrants that it is an “accredited investor” as defined under the Act.

9.

Redemption/Prepayment of Note:  This Note is subject to redemption at the option of the Company upon thirty (30) days prior written notice (subject to the Holder’s prior exercise of its right of conversion as set forth above), as a whole at any time, or in part from time to time, upon payment by the Company of 100% of the unpaid principal amount or such portion thereof so redeemed, plus accrued interest thereon through the date of redemption.

10.

Events of Default:  If any of the following conditions or events (“Events of Default”) shall occur and shall be continuing:

(i)

if the Company shall default in the payment of principal and/or interest accruing herein when the same becomes due and payable, whether at maturity or by declaration of acceleration or otherwise, and shall fail to cure such




 


default within fifteen days after written notice thereof from the Holder to the Company, if the Company fails to tender any payment due hereunder when the same becomes due; and shall fail to cure such default within fifteen days after written notice thereof from the Holder to the Company; or

(ii)

if the Company shall materially default in the performance of or compliance with any material term contained herein and such default shall not have been remedied within fifteen days after written notice thereof from the Holder to the Company; or

(iii)

if the Company shall make an assignment for the benefit of creditors, or shall admit in writing its inability to pay its debts as they become due, or a voluntary petition for reorganization under Title 11 of the Unites States Code (“Title 11”) shall be filed by the Company or an order shall be entered granting relief to the Company under Title 11 or a petition shall be filed by the Company in bankruptcy, or the Company shall be adjudicated a bankrupt or insolvent, or shall file any petition or answer seeking for itself any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statue, law or regulation, or shall file any answer admitting or not contesting the material allegations of a petition filed against the Company any such proceeding, or shall seek or consent to or acquiesce in the appointment of any trustee, receiver or liquidator of the Company or of all or any substantial part of the properties of the Company or if the Company or its directors or majority shareholders shall take any action looking to the dissolution or liquidation of the Company; or

(iv)

if within 120 days after the commencement of an action against the Company seeking a reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statue, law or regulation, such action shall not have been dismissed or nullified or all orders or proceedings thereunder affecting the operations or the business of the Company stayed, or if the stay of any such order or proceeding shall thereafter be set aside, or if, within 120 days after the appointment without the consent or acquiescence of the Company of any trustee, receiver or liquidator of the Company or of all or any substantial part of the properties of the Company such appointment shall not have been vacated;

then, and in any such event, the Holder may at any time (unless such Event of Default shall theretofore have been remedied) at its option, by written notice to the Company, declare the Note to be due and payable, whereupon the Note shall forthwith mature and become due and payable, together with interest accrued thereon, and thereafter interest shall be due, at the rate per annum hereinabove provided, on the entire principal balance until the same is fully paid, and on any overdue interest (but only to the extent permitted by law), without presentment, demand, protest or notice, all of which are hereby waived, subject however, to the other terms, including those relating to subordination, of this Note. No course of dealing and no delay on the part of Holder in exercising any right shall operate as a waiver thereof or otherwise prejudice such Holder’s rights, powers or remedies. No right, power or remedy conferred by this Note upon Holder shall be exclusive of any




 


other right, power or remedy referred to herein or now or hereafter available at law, in equity, by statute or otherwise.

11.

Notice:  All notices required or permitted to be given under this Note, including, without limitation, any Notice of Conversion, shall be in writing (delivered by hand or sent certified or registered mail, return receipt requested, or by nationally recognized overnight courier service) addressed to the respective party at the address indicated on the signature page of this Note. Any notice or other communication or deliveries hereunder shall be deemed given and effective on the earliest of (i) the second business day following the date of mailing, if sent by nationally recognized overnight courier service or (ii) upon actual receipt by the party to whom such notice is required to be given.

12.

Governing Law and Jurisdiction:  The Note shall be governed by the laws of the State of Florida. This Note and all issues arising out of this Note will be governed by and construed solely and exclusively under and pursuant to the laws of the State of Florida. Each of the parties hereto expressly and irrevocably agrees that any legal suit, action or proceeding arising out of or relating to this Agreement will be instituted exclusively in Broward County, Florida.

13.

Severability:  If any provision, paragraph or subparagraph of this Note is adjudged by any court to be void or unenforceable in whole or in part, this adjudication shall not affect the validity of the remainder of the Note, including any other provision, paragraph or subparagraph. Each provision, paragraph or subparagraph of this Note is separable from every other provision, paragraph and subparagraph and constitutes a separate and distinct covenant.

14.

Amendment:  This Note may only be amended in writing, duly endorsed by the parties hereto.

15.

Heading:  The headings in this Note are solely for convenience of reference and shall not affect its interpretation.

 

PAYMEON, INC.

 

 

 

 

 

 

 

 

 

 

 

 

 

HOLDER:

 

 

 

 






 C: 

1 Subsequent Filing that References this Filing

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 3/31/21  Basanite, Inc.                    10-K       12/31/20   63:5.2M                                   Edgar Filing LLC/FA
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