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verizonInvoice Number Account Number Date Due Page <br /> 9771833819 742058933-00001 10/05/16 2 of 47 <br /> Get Data Used Get Balance <br /> Get #DATA+SEND #BAL+SEND <br /> #MIN+SEND <br /> Payments $658.70 <br /> Previous Balance <br /> Payment—Thank You —658.70 <br /> Payment Received 08/18/16 —$658.70 <br /> Total Payments $.00 <br /> Balance Forward <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> SMB UNL Talk&TXT 30GB 09/11 —10/10 225.00 <br /> 22%Access Discount 09/11 —10/10 —49.50 <br /> $175.50 <br /> Subtotal <br /> $175.50 <br /> Total Account Charges and Credits <br /> Written notations included ireless Attn:Corpre Correspondence Teamreviewed or honored. Please send PO Box 5029 Wallingford, CT 06492respondence to: <br /> Ver <br /> y <br /> Automatic Pa <br /> ment Enrollment for Account:742058933-00001 CITY OF EUGENE <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 o <br /> setup Automatic Payment.You will be noted 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 /> terms ofour existing Customer Agreement.I agree that Verizon Wireless is not liable for erroneous bill statements or incorrect debits to my account.To <br /> agreement does not alter theY <br /> withdraw your authorization you must call Verizon mibWireless.xto ,as with your bank for any charges. 3.Return this slip with your payment.Do not send a voided chec . <br /> 1.Check this box. 2.Sign name in box below,as shown on the bill and date. <br /> ■ <br /> aLl - <br /> 0001271-0056412-0000002 of 0000064-C24-BK-6510-01272 <br />