NCC221103_NOI 84331 Payment Verification_20220318

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/16/2022 10:27:06 AM (NCG01 NOI Submission)
Approve by EADS\amorman1 3/17/2022 2:46:54 PM (Review - NOI 84331 Samaritan's Purse Warehouse)
• The task was assigned to Morman, Alaina by round robin distribution 3/16/2022 10:27 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 21, 2022 5:00 PM.
The priority is: High 3/16/2022 10:27 AM
by Workflow 3/17/2022 2:47:00 PM (Workflow Start Event)
Submit by Selkane, Aziza 3/18/2022 12:07:43 PM (Payment Verification for NCC221103)
F Samaritan's Purse
• Selkane, Aziza assigned the task to Selkane, Aziza 3/18/2022 12:06 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 28, 2022 5:00 PM. The
priority is: High 3/17/2022 2:47 PM

5 A7
Payment •
NORTH CAROLINA
Envlrmmm(af Quafhy
Project Name
Samaritan's Purse Warehouse
Lot Numbers
(If listed on the eNOI)
PID 1404762
NC Reference No.*
NCG01-2022-1103
Certificate of
NCC221103
Coverage (COC) No.*
Invoice Date
3/17/2022
Initial Invoice No.
NCC221103-2022
Initial Fee
$ 100.00
Invoice Due Date
4/16/2022
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
3/18/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
• electronic
check
Other
ePayment
623798829
Transaction Number*
NOI Tracking No.
84331
Tracking ID referenced upon submittal
This is an Express
No
Review Project
• Yes
Project Tracking ID
NCC-WILKE-2022-Samaritan's Purse Warehouse