Total Payment: $105.00

Payment From: Christine Stricker

Invoice Number: 24672-1

Payment Account: Checking x5051

Email: Christines@specialistsindermatology.com

Reference Number: 934-164

I authorize Code Plus Mechanical LLC, Service Provider, and/or bank to electronically debit the personal bank account or the business bank account of which I am an authorized signor as identified above to the terms stated here and if necessary to electronically credit the bank account to correct erroneous debits. This authorization shall remain in effect until Code Plus Mechanical LLC receives written notification from me of my intent to terminate and revoke this authorization at such time and in such manner as to afford Code Plus Mechanical LLC, the Service Provider, and/or the bank reasonable opportunity to act (Minimum 30 days).

If this is a recurring payment, I understand that if the total amount owed to Code Plus Mechanical LLC is increased, I authorize this plan to continue so long as the payment amount and frequency remains unchanged until the total amount owed to Code Plus Mechanical LLC is paid in full, or unless the plan is terminated or revoked earlier by me as above. I understand that the timing of the revocation may not allow for scheduled payments to be stopped.

I understand that this payment plan may be cancelled by Code Plus Mechanical LLC, the Service Provider, and/or the bank due to NSF (Non-sufficient Funds). I will be liable to pay an NSF fee of $25.00 (or the amount allowable by law), which may be automatically debited for each NSF.

I represent and warrant that I am authorized to execute this payment authorization for the purpose of implementing this payment plan with Code Plus Mechanical LLC. I indemnify and hold Code Plus Mechanical LLC, the Service Provider, and/or the bank harmless from damage, loss or claim resulting from all authorized actions hereunder.