NCC192265_Payment Verification_20191009

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/8/2019 8:22:33 AM (NCG01 NOI Submission)
Approve by Georgoulias, Bethany 10/9/2019 1:11:04 PM (Review- Construction NOI 16865)
• Georgoulias, Bethany reassigned the task to Georgoulias, Bethany 10/9/2019 12:34 PM
• The task was assigned to Farkas, Jim J by round robin distribution 10/8/2019 8:22 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 10, 2019 5:00
PM 10/8/2019 8:22 AM
Submit by McCoy, Suzanne 10/9/2019 2:43:26 PM (Payment Verification for NCC192265)
* Mavis Tire Supply LLC
• McCoy, Suzanne assigned the task to McCoy, Suzanne 10/9/2019 2:42 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 20, 2019 5:00
PM 10/9/2019 1:11 PM

NORTH CAROLINA
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Project Tracking ID*
NCC-CATAW-2019-Hickory Mavis Discount Tire
NC Reference No.*
NCG01-2019-2265
Certificate of
NCC192265
Coverage (COC)
No. *
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* r Payment Received.
f Payment NOT RECEIVED.
Date Payment
10/9/2019
Received*
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
r Other
Check Number*
252443
NOI Tracking No.
16865
Tracking ID referenced upon subaittal
This is an Express
r No
Review Project
r Yes