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b. <br /> verizonInvoice Number Account Number Date Due Page <br /> 0770207129 $72298$27-00001 09/05116: 2 of°4 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN+SEND #DATA+SEND #BAL+ SEND <br /> Payments <br /> Previous Balance $537.74 <br /> Payment—Thank You <br /> Payment Received 08/05/16 —537.74 <br /> Total Payments —$537.74 <br /> Balance Forward $.00 <br /> Writtefl notations included witiror an your Paymeflt il n* I*reviewedor honored.,Please send.ctfrrespOndenCe'to: <br /> ttermon llfireless Attn:Correspond�team_PO Box�9"Wallingfr rd,CT 06492 <br /> Automatic Payment Enrollment for Account:872298827-00001 CITY OF EUGENE-1 MB SPRINKLERS <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 /> 111 0 I 1 a <br /> 0015366 0053820-0000002 of 0000006-GL LI 6410 15381 <br />