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verizon <br /> z�} <br /> Invoice Number Account Number Date Due Page <br /> 9778416093 242059101-00004 02/05/17 2 of 32 <br /> Get Minutes Used _ <br /> Get Data Used <br /> Get Balance <br /> #MIN+SEND #DATA+SEND <br /> #BAL+SEND <br /> Payments <br /> Previous Balance $476.10 <br /> Payment—Thank You <br /> Payment Received 12/22/16 —476.10 <br /> Total Payments <br /> —$476.10 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> New Plan <br /> SMB UNL Talk&TXT 40GB 12/11 —01/10 300.00 <br /> $300.00 per month/full month on new plan <br /> 22%Access Discount 12/11 —01/10 —66.00 <br /> Month in Advance <br /> SMB UNL Talk&TXT 40GB 01/11 —02/10 300.00 <br /> 22%Access Discount 01/11 —02/10 —66.00 <br /> Data SMB 30GB Refund 12/11 —01/10 —185.00 <br /> 22%Access Discount—Reversal 12/11 —01/10 40.70 <br /> These are the normal monthly charges billed in advance. <br /> Subtotal <br /> $323.70 <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 PO Box 50.2.9 Wallingford, CT 06492 <br /> Automatic Payment Enrollment for Account:242059101-00004 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 /> ■ <br /> LI <br /> I ■ <br /> 0003214-0068068-0)00002 of 0000058-C23-F1-5710-03217 <br />