ver zon" <br /> Invoice Number Account Number Date Due Page <br /> 9753781660 '7742058933-00001';11/05/15 2 of 16 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND <br /> #BAL+SEND <br /> Explanation of Charges Payments <br /> Verizon Wireless'Surcharges Previous Balance $139.20 <br /> - Verizon Wireless' Surcharges include (i) a Regulatory Charge <br /> - (which helps defray various government charges we pay including Payment—Thank You <br /> - government number administration and license tees); (ii) a Payment Received 09/30/15 —139.20 <br /> - Federal Universal Service Charge (and, it applicable, a State <br /> Universal Service Charge)to recover charges imposed on us by Total Payments —$139.20 <br /> the government to support universal service; and (iii) an Balance Forward $.00 <br /> Administrative Charge, which helps defray certain expenses we <br /> - incur, including: charges we, or our agents, pay local telephone <br /> - companies for delivering calls from our customers to their <br /> usif- customers; tees and assessments on our network facilities and Account Charges and Credits <br /> services; property taxes; and the costs we incur responding to <br /> regulatory obligations. Please note that these are Verizon Account Monthly Charges <br /> - Wireless charges, not taxes.These charges, and what's included, <br /> are subject to change from time to time. Data Plan 8GB 10/11 —11/10 50.00 <br /> 22%Access Discount 10/11 —11/10 —11.00 <br /> - Taxes,Governmental Surcharges and Fees Subtotal $39.00 <br /> Includes sales, excise and other taxes and governmental <br /> surcharges and fees that we are required by law to bill <br /> customers. These taxes, surcharges and tees may change from Total Account Charges and Credits $39.00 <br /> time to time without notice. <br /> Late Fee Information <br /> A late payment applies for unpaid balances.The charge is the <br /> greater of S5 or 1.5%per month,or as permitted by law. <br /> Verizon Wireless'Other Charges and Credits <br /> Includes charges for products and services,and credits owing. <br /> --Correspondence Address• Verizon Wireless.Attn Correspondence Team PO-Box 502TWallingford, CT-06492 I <br /> Automatic Payment Enrollment for Account:742058933-00001 CITY OF EUGENE <br /> By signing below,you authorize Verizon Wireless to electronically debit your bank account each month for the total balance due on your account.The check you send wit be used to <br /> setup Automatic Payment. You will be notified each month of the date and amount of the debit 10 days in advance of the payment. I understand and accept these terms. This <br /> agreement does not alter the terms of your existing Customer Agreement.I agree that Verizon Wreless is not liable for erroneous bill statements or incorrect debits to my account.To <br /> withdraw your authorization you must call Verizon Wireless.Check with your bank for any charges. <br /> 1.Check this box. 2.Sign name in box below,as shown on the bill and date. 3.Return this slip with your payment.Do not send a voided check. <br /> II El <br /> Changing your billing address for Account:742058933-00001 CITY OF EUGENE <br /> Use this space or sign in to My Vedzon at vzw.com/changeaddress to change the mailing address where we send your bill.If we do not have your most recent email address,provide it <br /> below and we'll use it to tell you important information about your Verizon Wireless service.Allow 2 billing cycles for the address change to take effect. <br /> New Address Confirming or changing your service address <br /> For each of your mobile numbers,in order to bill taxes and <br /> City surcharges correctly we need a service address-which is a <br /> street address(not a PO Box)that is the home or primary <br /> State2ip _ business address of the person who uses that number.To <br /> Work Phone Home Phone confirm or change the service address for any of your mobile <br /> numbers,sign into My Verizon at vzw.com/servioeaddress. <br /> Email <br /> 0019749-0167808-0000002 of 0000026{32-8876610-19768 <br />