NCC203989_NOI 31112 Payment Verification_20200914

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/9/2020 8:36:28 AM (NCG01 NOI Submission)
Approve by Clark, Paul 9/11/2020 12:41:35 PM (Review- Construction NOI 31112)
• Garcia, Lauren V reassigned the task to Clark, Paul 9/10/2020 10:56 AM
. The task was assigned to Garcia, Lauren V by round robin distribution 9/9/2020 8:36 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 11, 2020 5:00
PM 9/9/2020 8:36 AM
Submit by Selkane, Aziza 9/14/2020 10:42:19 AM (Payment Verification for NCC203989)
* James R Basinger
• Selkane, Aziza assigned the task to Selkane, Aziza 9/14/2020 10:40 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 23, 2020 5:00 PM
9/11/2020 12:41 PM

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•
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• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Carolina's Rehab Enabling Plan
NC Reference No.*
NCG01-2020-3989
Certificate of
NCC203989
Coverage (COC)
No. *
Invoice Date
9/11/2020
Initial Invoice No.
NCC203989-2020
Initial Fee
$ 100.00
Invoice Due Date
10/11/2020
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
9/14/2020
Received *
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
r Other
ePayment
535181086
Transaction
Number*
NOI Tracking No.
31112
Tracking ID referenced upon subrrittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-MECKL-2020-Carolina's Rehab Enabling Plan