NCC223484_NOI 108671 Payment Verification_20221014

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/6/2022 9:39:56 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/6/2022 9:46:15 AM (Review - NOI 108671 Modera LoSo)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/6/2022 9:40 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 11, 2022 5:00
PM 10/6/2022 9:40 AM
by Workflow 10/6/2022 9:46:23 AM (Workflow Start Event)
Submit by Tran, Kieu M 10/14/2022 10:11:20 AM (Payment Verification for NCC223484)
F Balagee Subramanian
• Tran, Kieu M assigned the task to Tran, Kieu M 10/14/2022 10:10 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 17, 2022 5:00
PM 10/6/2022 9:46 AM

Payment •
NORTH CAROLINA
Environmental Quaftfy
Project Name
Modera LoSo
Lot Numbers
(If listed on the eNOl)
NC Reference No.*
NCG01-2022-3484
Certificate of
NCC223484
Coverage (COC) No.*
Invoice Date
10/6/2022
Initial Invoice No.
NCC223484-2022
Initial Fee
$ 100.00
Invoice Due Date
11/5/2022
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 eNOI at this step.
Payment Received*
Payment Received.
Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
10/14/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
ePayment
657640854
Transaction Number*
NOI Tracking No.
108671
Tracking ID referenced upon submittal
This is an Express
No
Review Project
Yes
Project Tracking ID
NCC-MECKL-2022-Modera LoSo