NCC210632_NOI 42432 Payment Verification_20210203

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/29/2021 4:33:55 PM (NCG01 NOI Submission)
Approve by Clark, Paul 2/1/2021 4:52:55 PM (Review- Construction NOI 42432)
• The task was assigned to Clark, Paul by round robin distribution 1/29/2021 4:34 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 2, 2021 5:00
PM 1/29/2021 4:34 PM
Submit by Selkane, Aziza 2/3/2021 9:40:17 AM (Payment Verification for NCC210632)
* Shermin L Pelinski
• Selkane, Aziza assigned the task to Selkane, Aziza 2/3/2021 9:39 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 15, 2021 5:00 PM
2/1/2021 4:53 PM

SfA7$ q,
•
V.
• yrnent Verification
NORTH CAROLINA
Envlro me tufQuuftty
Project Name
Fields Mercedes
NC Reference No.*
NCG01-2021-0632
Certificate of
NCC210632
Coverage (COC)
No. *
Invoice Date
2/1/2021
Initial Invoice No.
NCC210632-2021
Initial Fee
$ 100.00
Invoice Due Date
3/3/2021
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
2/3/2021
Received *
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
r check
r NO PAYMENT RECEIVED
f Other
ePayment
556612261
Transaction
Number*
NOI Tracking No.
42432
Tracking ID referenced upon subnittal
This is an Express
r No
Review Project
r Yes
Project Tracking ID
NCC-HENDE-2021-Fields Mercedes