NCC192970_Billing Contact Update Record_20220105

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 1/5/2022 10:10:48 AM (Contact Changes Submitted)

Certificate of NCC192970
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2019-2970
Original NOI No.* 18934
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
Brunswick -Columbus International Park, Inc.
Project Name International Logistics Park
Address 4601 Andrew Jackson Hwy NE, Northwest, NC
County Brunswick
Latitude 34.3026
Longitude-78.1875
Date COC Issued * 12/10/2019
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes' to revise Billing Contact details.
Changed? No
• Yes
Billing Email
NEW Billing Email
Billing Telephone No.
NEW Billing
Telephone No.
[e-mail]
[phone]
(Optional)
Change Requested Lori Riley via e-mail request for copy of invoice 1/5/2022
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation Additional contact for billing
(Optional)
Date * 01 /05/2022