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verizon✓ <br /> Invoice Number Account Number Date Due Page <br /> • 9755383199 542058966-00001 12/05/15 2 of 22 <br /> Get Minutes Used Get Data Used Get Balance <br /> Explanation of Charges Payments <br /> Verizon Wireless'Surcharges Previous Balance $131.40 <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 fees); (ii) a Payment Received 11/06/15 —131.40 <br /> - Federal Universal Service Charge (and, it applicable, a Stale <br /> Universal Service Charge)to recover charges imposed on us by Total Payments —$131.40 <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 /> customers; fees 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 lime to time. <br /> Previous Plan <br /> Data Plan 6GB Refund 10/11 —11/10 —40.00 <br /> - Taxes,Governmental Surcharges and Fees $40.00 per month/full month refunded <br /> - Includes sales, excise and other taxes and governmental <br /> surcharges and tees that we are required by law to hill 22%Access Discount—Reversal 10/11 —11/10 8.80 <br /> customers. These taxes, surcharges and tees may change from <br /> New Plan <br /> time to time without notice. <br /> Data SMB 30GB 10/11 —11/10 185.00 <br /> Understanding Your Prorated(partial month)Charges $185.00 per month!full month on new plan <br /> Prorated charges occur when you add new service, or make a 22%Access Discount 10/11 — 11/10 —40.70 <br /> change to your existing service, in the middle of your bill cycle. Month in Advance <br /> Prorated charges are calculated by determining the daily charge, <br /> and then by multiplying the daily charge by the number of days Data SMB 30GB 11/11 —12/10 185.00 <br /> the service was used. 22%Access Discount 11/11 —12/10 —40.70 <br /> It a plan change is effective as o1 a date during the bill cycle,your These are the normal monthly charges billed in advance. <br /> proration will include a credit for unused days on the old plan, Subtotal $257.40 <br /> and a charge for the days used on your new plan. <br /> Total Account Charges and Credits $257.40 <br /> Correspondence Address Verizon Wireless Attn: Correspondenge.Team PO Box 5029 Wallingford, CT 06492 I <br /> Automatic Payment Enrollment for Account:542058966-00001 CITY OF EUGENE PWM/POS <br /> By signing below,you authorize Verizon Wireless to electronically debit your hank account each month for the total balance due on your account.The check you send will 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 Wireless 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 /> ® ❑ <br /> Changing your billing address for Account:542058966-00001 CITY OF EUGENE PWM/POS <br /> Use this space or sign in to My Verizon 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 n <br /> below and we'll use it to tee 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 /> State/Zip 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.conVserviceaddres. <br /> Email <br /> 0003744-0079687.00001x12 of 0000040C234 L6710 03747 <br />