NCC211408_Contact Update Record_20220325

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Selkane, Aziza 3/25/2022 1:27:03 PM (Contact Changes Submitted)

Certificate of NCC211408
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2021-1408
Original NOI No.* 47414
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
BOMA NORTH CAROLINA, LLC
Project Name Quail Run at Calebs Creek
Address Teague Lane, Kernersville, NC
County Forsyth
Latitude 36.0585
Longitude-80.0921
Date COC Issued * 03/16/2021
Prior Rescission Date This field will populate only if COC has already been rescinded.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 [e-mail]
Billing Telephone No. 3366698189
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Ravindra Bissram
(Previous)
Site Contact Title Senior Project Manager
(Previous)
Organization Fleming Engineering, Inc
(Previous)
First Name (New)* Turner

Last Name (New) * Perrow
NEW Site Contact* Reflects any revisions above
Turner Perrow
NEW Site Contact Senior Project Manager
Title
NEW Organization Fleming Engineering, Inc.
This field is not required on the NOI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact
Email*
[e-mail]
Site Contact 336-544-6426
Telephone No.
(Previous)
NEW Site Contact 336-669-8189
Telephone No.*
Site Contact Mailing 8518 Triad Drive, 0, Colfax, NC 27235
Address (Previous)
NEW Site Contact Street Address
Mailing Address* 1110-A Dover Road
Address Line 2
City
Greensboro
Postal / Zip Code
27408
State / Province / Region
NC
Country
United States
Change Requested Sarah Cole by email on 3/16/2022
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/25/2022