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verizon✓ Invoice Number Account Number Date Due Page 9763567454 542058966-00001 05/05/16 2 of 25 Get Minutes Used Get Data Used Get Balance #MIN +SEND #DATA+SEND • #BAL+SEND Payments Previous Balance $320.88 Payment—Thank You Payment Received 04/01/16 —320.88 Total Payments —$320.88 Balance Forward $.00 Account Charges and Credits Account Monthly Charges New Plan SMB UNL Talk&TXT 30GB 04/08—04/10 21.77 $225.00 per month/3 days on new plan • 22%Access Discount 04/08-04/10 —4.79 Month in Advance SMB UNL Talk&TXT 30GB 04/11 —05/10 225.00 22%Access Discount 04/11 —05/10 —49.50 Data SMB 30GB Refund 04/08—04/10 —17.90 22%Access Discount—Reversal 04/08—04/10 3.94 These are the normal monthly charges billed in advance. Subtotal $178.52 Written notations Included with or on your payment will not be reviewed or hon`ored7Please send correspondence to: „ Verizon Wireless Attn: Correspondence Team PO Box,5029 Wallingford,.CT 06492 Automatic Payment Enrollment for Account:54205896600001 CITY OF EUGENE PWM/POS 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 setup Automatic Payment. You will be notified each month of the dale and amount of the debt 10 days in advance of the payment. I understand and accept these temis. This 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 withdraw your authorization you must call Verizon Wireless.Check with your bank for any charges. 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. ■ ❑ ■ 00032411-0069160-0000002 010000(46{13-r1:0010-03243