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ver" zonV <br /> Invoice Number Account Number Date Due Page <br /> di •9760229317 r 242059101-00002 03/05/16 •2 of 31 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $375.10 <br /> Payment-Thank You <br /> Payment Received 02/01/16 -375.10 <br /> Total Payments -$375.10 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Data SMB 30GB 02/11 -03/10 185.00 <br /> 22%Access Discount 02/11 -03/10 -40.70 <br /> Subtotal $144.30 <br /> Total Account Charges and Credits $144.30 <br /> i- `Written notations inclifdedwith or-on your paymenttwill snot be reviewed or honored Please senticorrespondence to:, w; d <br /> „ . ,,, +.. , :.:. .Verizati.Wireless Attn: Correspondence Team PO Box,5029 Wallingford„CT.;06.4.92 <br /> Automatic Payment Enrollment for Account:242059101-00002 CITY OF EUGENE PWM/POS <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 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 /> 111 <br /> • <br /> • <br /> 0003 75 3 0080140 0000102 of 0000056-C23-FLS8I0-03756 <br />