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verizon� <br /> Invoice Number Account Number Date Due Page <br /> _. _ _ <br /> 9761864192 242059101-00003 04/05/16. 2 ot31 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND gBAL+SEND <br /> Payments <br /> Previous Balance $397.72 <br /> Payment—Thank You <br /> Payment Received 02/25/16 —397.72 <br /> Total Payments —$397.72 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Data SMB 30GB 03/11 —04/10 185.00 <br /> 22%Access Discount 03/11 -04/10 —40.70 <br /> Subtotal $144.30 <br /> Total Account Charges and Credits $144.30 <br /> • <br /> 'Written notations Included itt or`on your payme'nt`will not'be.revlewetl:"or honored7Pleasersend correspondence to 7 <br /> wVerizon Wireless Attni.Correspondence Team,P,0 Box,5029 Wallingford,,CT 06492 <br /> Automatic Payment Enrollment for Account:242059101-00003 CITY OF EUGENE PWM/POS <br /> By signing below,you authorize Verizon Wireless to electronically debt 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 debt 10 days in advance of the payment. i understand and accept these terms. This <br /> agreement does not after the terms of your existing Customer Agreement.I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debts 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 /> 0003443-00/349/-0000002 of 0000058023-FI.-591003446 <br />