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verizonv <br /> Invoice Number Account Number Date Due Page <br /> 9760366551 942058818-00001 03/05/16 2 of 29 J <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND. • #BAL+SEND <br /> • Payments <br /> Previous Balance $349.93 <br /> Payment—Thank You <br /> Payment Received 02/01/16. —349.93 <br /> Total Payments —$349.93 <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 /> Written notations incltided with or on your payment will 114 be reviewed or honored: Please send correspondence to: 1 <br /> Verizon,Wireless Attn;.Correspondence.Team,P0 Box.5029 Wallingford CT.06492 ...., ... .... <br /> Automatic Payment Enrollment for Account:942058818-00001 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 /> ■ <br /> 0003749-13030025-0000002 of 0000054.023-n.-5010-03752 <br />