NCC201026_Payment Verification_20200316

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/14/2020 9:36:37 AM (NCG01 NOI Submission)
Approve by Clark, Paul 3/16/2020 10:49:30 AM (Review- Construction NOI 23080)
• The task was assigned to Clark, Paul by round robin distribution 3/14/2020 9:37 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 18, 2020 5:00
PM 3/14/2020 9:37 AM
Submit by Garcia, Lauren V 3/16/2020 3:24:37 PM (Payment Verification for NCC201026)
* Khan & Associates Inc.
Nationwide Insurance Agency
• Garcia, Lauren V assigned the task to Garcia, Lauren V 3/16/2020 3:22 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 27, 2020 5:00 PM
3/16/2020 10:49 AM

SfA7$ q,
•
V.
• yrnent Verification
NORTH CAROLINA
Envtro me tufQuuftty
Project Tracking ID* NCC-GUILF-2020-Islamic Center of the Triad
NC Reference No.*
NCG01-2020-1026
Certificate of
NCC201026
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
3/16/2020
Received*
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
r Other
Check Number*
320304
NOI Tracking No.
23080
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes