verizon k <br /> Invoice Number Account Number Date Due Page <br /> 9790775514 542058966-00001 09/05/17 2 of 31 <br /> Get Minutes Used Get Data Used Get Balance <br /> #MIN +SEND #DATA+SEND #BAL+SEND <br /> Payments <br /> Previous Balance $474.78 <br /> Payment—Thank You <br /> Payment Received 07/26/17 —474.78 <br /> Total Payments —$474.78 <br /> Balance Forward $.00 <br /> Account Charges and Credits <br /> Account Monthly Charges <br /> Previous Plan <br /> Data SMB 30GB Refund 07/11 —08/10 —185.00 <br /> $185.00 per month/full month refunded <br /> 22%Access Discount—Reversal 07/11 —08/10 40.70 <br /> New Plan <br /> Data SMB 40GB 07/11 —08/10 260.00 <br /> $260.00 per month/full month on new plan <br /> 22%Access Discount 07/11 —08/10 —57.20 <br /> Month in Advance <br /> Data SMB 40GB 08/11 —09/10 260.00 <br /> 22%Access Discount 08/11 —09/10 —57.20 <br /> These are the normal monthly charges billed in advance. <br /> Subtotal $261.30 <br /> Total Account Charges and Credits $261.30 <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 P.O. Box 291089 Columbia, SC 29229 <br /> Automatic Payment Enrollment for Account:542058966-00001 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 /> • L1 <br /> II <br />--- <br /> 00021..26-0042862-0000002 of 0000056-C23-FL-6410-02128 <br />