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verizon <br /> Invoice Number Account Number Date Due Page <br /> 9787234300 242059101-00003 07/05/17 2 of 27 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL +SEND <br /> Payments <br /> Previous Balance $343,71 <br /> Payment—Thank You <br /> Payment Received 05/23/17 —343.71 <br /> Total Payments —$343.71 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> New Plan <br /> SMB UNL Talk&TXT 30GB 05/11 —06/10 225.00 <br /> $225.00 per month/full month on new plan <br /> 22%Access Discount 05/11 —06/10 —49.50 <br /> Month in Advance <br /> SMB UNL Talk&TXT 30GB 06/11 —07/10 225.00 <br /> 22%Access Discount 06/11 —07/10 —49.50 <br /> Data SMB 30GB Refund 05/11 —06/10 —185.00 <br /> 22%Access Discount—Reversal 05/11 —06/10 40.70 <br /> These are the normal monthly charges billed in advance. <br /> Subtotal $206.70 <br /> Total Account Charges and Credits $206.70 <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 P.O. Box 291089 Columbia, SC 29229 <br /> Automatic Payment Enrollment for Account:242059101-00003 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 cat 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 /> • LI1 U <br /> 000.,142-0043479-0000002 of 0000050.023-FL-6210-02144 <br />