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verizonY <br /> Invoice Number Account Number Date Due Page <br /> 8771 329 942058818-001 1 °• 5/16 2 of 32 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $394.16 <br /> Payment-Thank You <br /> Payment Received 08/05/16 -394.16 <br /> Total Payments -$394.16 <br /> Balance Forward $.0 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Data SMB 30GB 08/11 -09/10 185.00 <br /> 22%Access Discount 08/11 -09/10 -40.70 <br /> Subtotal $144.30 <br /> Total Account Charges and Credits $144.30 <br /> Written notations included with or on your payment Will not be:reviewed or honored.Please send correspondence to: <br /> Verizon Wireless Attn:Correspondence Team Pa 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 /> NEll ■ <br /> 0002032-0065148-0000002 o10000058 C23 FL-6410-02005 <br />