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Verinnwireless Invoice Number Account Number Date Due Page 9704366373 542011189 -00001 05/30/13 2 of 55 Get Minutes Used Get Data Used Get Balance #MIN + SEND #DATA + SEND #BAL + SEND Explanation of Charges Payments Verizon Wireless' Surcharges Previous Balance $.00 Verizon Wireless' Surcharges include (i) a Regulatory Charge - (which helps defray various government charges we pay including No Payment Received government number administration and license fees); (ii) a Total Payments $.00 Federal Universal Service Charge (and, if applicable, a State Universal Service Charge) to recover charges imposed on us by Balance Forward $.00 the government to support universal service; and (iii) an Administrative Charge, which helps defray certain expenses we incur, including charges we or our agents pay local telephone companies for delivering calls from our customers to their customers, fees and assessments on our network facilities and services, and costs and charges associated with new cell site - construction, local number portability, and other government mandates. Please note that these are Verizon Wireless charges, not taxes. These charges, and what's included, are subject to change from time to time. Taxes, Governmental Surcharges and Fees - Includes sales, excise and other taxes and governmental surcharges and fees that we are required by law to bill customers. These taxes, surcharges and fees may change from time to time without notice. Understanding Your Prorated (partial month) Charges Prorated charges occur when you add new service, or make a change to your existing service, in the middle of your bill cycle. Prorated charges are calculated by determining the daily charge, and then by multiplying the daily charge by the number of days the service was used. If a plan change is effective as of a date during the bill cycle, your proration will include a credit for unused days on the old plan, and a charge for the days used on your new plan. 40110 ll e1140- Ir !ICeri St 0 At 40#140 + e r" i � __...�� ................ .... ,......, �.. a .ri,. _,... . - - - -- - -- ..., ---- - -.... ..,...,:.. ..,..., ...... Automatic Payment Enrollment for Account: 542011189-00001 CITY OF EUGENE 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 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 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 withdraw your authorization you must call Verizon Wireless. Check with your bank for any charges. I 1. Check this box. 2. Sign name in box below, as shown on the bill and date. 3. Return this slip with your check for this month's payment. • REII l ■ Changing your billing address for Account: 542011189 -00001 CITY OF EUGENE Use this space or sign in to My Verizon at vzw.comlchangeaddress to change the mailing address where we send your bit. If we do not have your most recent email address, provide it below and well use it to tell you important information about your Verizon Wireless service. Allow 2 billing cycles for the address change to take effect. New Address Confirming or changing your service address For each of your mobile numbers, in order to bill taxes and City _ surcharges correctly we need a service address - which is a street address (not a PO Box) that is the home or primary State/Zip _ business address of the person who uses that number. To Work Phone Horne Phone confirm or change the service address for any of your mobile numbers, sign in to My Verizon at vzw.com /serviceaddress Email Order #: 6104 Copy #: 05 Control #40000067- 00003138