NCC210446_NOI 41699 Payment Verification_20210126

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/25/2021 10:44:32 AM (NCG01 NOI Submission)
Approve by Meloy, Michael 1/25/2021 11:52:05 AM (Review- Construction NOI 41699)
• The task was assigned to Meloy, Michael by round robin distribution 1/25/2021 10:45 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 27, 2021 5:00
PM 1/25/2021 10:45 AM
Submit by Selkane, Aziza 1/26/2021 9:16:11 AM (Payment Verification for NCC210446)
* AndrewAuerbach
• Selkane, Aziza assigned the task to Selkane, Aziza 1/26/2021 9:15 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 8, 2021 5:00 PM
1/25/2021 11:52 AM

SfA7$ q,
•
V.
• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Adigun Medical Office
NC Reference No.*
NCG01-2021-0446
Certificate of
NCC210446
Coverage (COC)
No. *
Invoice Date
1/25/2021
Initial Invoice No.
NCC210446-2021
Initial Fee
$ 100.00
Invoice Due Date
2/24/2021
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
1 /26/2021
Received *
(Or, if not received, date rejected for no paynent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
r Other
ePayment
555418367
Transaction
Number*
NOI Tracking No.
41699
Tracking ID referenced upon subnittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-CHATH-2021-Adigun Medical Office