NCC193124_Payment Verification_20191213

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/6/2019 9:10:09 AM (NCG01 NOI Submission)
Approve by Farkas, Jim J 12/9/2019 3:21:19 PM (Review- Construction NOI 19194)
• The task was assigned to Farkas, Jim J by round robin distribution 12/6/2019 9:10 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 10, 2019 5:00
PM 12/6/2019 9:10 AM
Submit by McCoy, Suzanne 12/13/2019 2:12:40 PM (Payment Verification for NCC193124)
* Davidson County Farm Bureau
• McCoy, Suzanne assigned the task to McCoy, Suzanne 12/13/2019 2:12 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 20, 2020 5:00 PM
12/9/2019 3:21 PM

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• yrnent Verification
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Project Tracking ID* NCC-DAVID-2019-Davidson County Farm Bureau, Inc.
NC Reference No.*
NCG01-2019-3124
Certificate of
NCC193124
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.
r Payment NOT RECEIVED.
Date Payment
12/13/2019
Received*
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
r Other
Check Number*
8789
NOI Tracking No.
19194
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes