NCC200261_Payment Verification_20200123

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/21/2020 2:27:43 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 1/21/2020 4:06:08 PM (Review- Construction NOI 20933)
• The task was assigned to Morman, Alaina by round robin distribution 1/21/2020 2:28 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 23, 2020 5:00
PM 1/21/2020 2:28 PM
Submit by McCoy, Suzanne 1/23/2020 7:25:15 AM (Payment Verification for NCC200261)
* Matthew Baker
• McCoy, Suzanne assigned the task to McCoy, Suzanne 1/23/2020 7:24 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 3, 2020 5:00 PM
1/21/2020 4:06 PM

VerificationPayrmnt
NORTH CAROLINA
Environmental Quvllly
Project Tracking ID*
NCC-FORSY-2020-Clemmons Medical Office
NC Reference No.*
NCG01-2020-0261
Certificate of
NCC200261
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
1 /23/2020
Received*
Method of Payment*
r electronic
f check
r NO PAYMENT RECEIVED
f Other
ePayment
499924779
Transaction
Number*
NOI Tracking No.
20933
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes