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verizon <br /> Invoice Number Account Number Date Due Page <br /> 9765276832 872298827-00001,--;06/05/16 2 oto <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $266.98 <br /> Payment—Thank You <br /> Payment Received 04/28/16 —266.98 <br /> Total Payments —5266.98 <br /> Balance Forward $.00 <br /> Written notations included with or on your ymentwill not be reviewed or honored.Please send correspondence to: <br /> Verizon Wireless Attn:ICorrespondence Team PO Box 5029 W_allin_gford •CT 06.4.9.2_ _ <br /> Automatic Payment Enrollment for Account:872298827-00001 CITY OF EUGENE-1 MB SPRINKLERS <br /> By signing below,you authorize Verizon Wireless to electronicaly 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 amount.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 /> N <br /> 001 5 864-005 64.14 0000002 of 0000006CII-L1-6110 15879 <br />