NCC232119_NOI 149729 Payment Verification_20230718

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 7/13/2023 8:26:57 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 7/13/2023 8:53:07 AM (Review-NOI 149729 C.W.Williams Community Health
Center)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:July 18,2023 5:00 PM
7/13/2023 8:27:05 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 7/13/2023 8:27:05 AM
Submit by Tev.Holloman 7/18/2023 10:22:35 AM (Payment Verification for NCC232119)
0 C.W.Williams Community Health Center, Inc.
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 24,2023 5:00 PM
7/13/2023 8:53:23 AM
• Tev.Holloman assigned the task to Tev.Holloman 7/18/2023 10:21:53 AM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name C.W.Williams Community Health Center
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOl)
NC Reference No.* NCG01-2023-2119
Certificate of NCC232119
Coverage(COC)No.*
Invoice Date 7/13/2023
Initial Invoice No. NCC232119-2023
Initial Fee $ 100.00
Invoice Due Date 8/12/2023
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 7/18/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 700735961
Transaction Number*
NOI Tracking No. 149729
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-MECKL-2023-C.W.Williams Community Health Center