NCC200814_Payment Verification_20200228

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/28/2020 9:31:45 AM (NCG01 NOI Submission)
Approve by Clark, Paul 2/28/2020 9:39:25 AM (Review- Construction NOI 22560)
• The task was assigned to Clark, Paul by round robin distribution 2/28/2020 9:31 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 3, 2020 5:00 PM
2/28/2020 9:31 AM
Submit by McCoy, Suzanne 2/28/2020 2:46:03 PM (Payment Verification for NCC200814)
* Kelway Howard
• McCoy, Suzanne assigned the task to McCoy, Suzanne 2/28/2020 2:45 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 10, 2020 5:00 PM
2/28/2020 9:39 AM

VerificationPayrmnt
NORTH CAROLINA
Environmental Quvllly
Project Tracking ID*
NCC-GUILF-2020-Womens Outpatient Center
NC Reference No.*
NCG01-2020-0814
Certificate of
NCC200814
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
2/28/2020
Received*
Method of Payment*
r electronic
f check
r NO PAYMENT RECEIVED
f Other
ePayment
505834371
Transaction
Number*
NOI Tracking No.
22560
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes