NCC204928_NOI 34487 Payment Verification_20201102

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/29/2020 10:25:59 AM (NCG01 NOI Submission)
Approve by Gamble, Aana C 10/30/2020 9:23:42 AM (Review- Construction NOI 34487)
. The task was assigned to Gamble, Aana C by round robin distribution 10/29/2020 10:26 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 2, 2020 5:00
PM 10/29/2020 10:26 AM
Submit by Selkane, Aziza 11/2/2020 11:23:03 AM (Payment Verification for NCC204928)
* Dave Richardson
• Selkane, Aziza assigned the task to Selkane, Aziza 11/2/2020 11:22 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 11, 2020 5:00
PM 10/30/2020 9:23 AM

SfA7$ q,
•
V.
• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Rocky Mount Mills Assisted Living
NC Reference No.*
NCG01-2020-4928
Certificate of
NCC204928
Coverage (COC)
No. *
Invoice Date
10/30/2020
Initial Invoice No.
NCC204928-2020
Initial Fee
$ 100.00
Invoice Due Date
11/29/2020
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 Payme nt
11 /2/2020
Received *
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
f Other
ePayment
542705871
Transaction
Number*
NOI Tracking No.
34487
Tracking ID referenced upon subnittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-NASI-1-2020-Rocky Mount Mills Assisted Living