NCC203961_NOI 30988 Payment Verification_20200911

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/4/2020 9:56:45 AM (NCG01 NOI Submission)
Approve by Morman, Alaina 9/10/2020 11:26:25 AM (Review- Construction NOI 30988)
• Gwinn, Matt reassigned the task to Morman, Alaina 9/8/2020 8:05 AM
. The task was assigned to Gwinn, Matt by round robin distribution 9/4/2020 9:56 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 8, 2020 5:00
PM 9/4/2020 9:56 AM
Submit by Selkane, Aziza 9/11/2020 10:00:11 AM (Payment Verification for NCC203961)
* Chris West
• Selkane, Aziza assigned the task to Selkane, Aziza 9/11/2020 9:59 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 22, 2020 5:00 PM
9/10/2020 11:26 AM

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•
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• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Family Foot & Ankle Physicians
NC Reference No.*
NCG01-2020-3961
Certificate of
NCC203961
Coverage (COC)
No. *
Invoice Date
9/10/2020
Initial Invoice No.
NCC203961-2020
Initial Fee
$ 100.00
Invoice Due Date
10/10/2020
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 eNO1 at this step.
Payment Received* r Payment Received.
r Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
9/11/2020
Received *
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
f Other
ePayment
534984591
Transaction
Number*
NOI Tracking No.
30988
Tracking ID referenced upon subnittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-PITT-2020-Family Foot & Ankle Physicians