NCC240035_NOI 176624 Payment Verification_20240108

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 1/4/2024 1:39:23 PM(NCG01 NOI Submission)
Approve by Brooklyn.Broussard 1/5/2024 6:31:19 AM(Review-NOI 176624 Broughton Hospital Maintenance
Facility)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:January 9,2024 5:00 PM
1/4/2024 1:39:34 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 1/4/2024 1:39:34 PM
Submit by Tev.Holloman 1/8/2024 10:36:37 AM (Payment Verification for NCC240035)
0 NV5 INC
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: February 16,2024 5:00 PM
1/5/2024 6:31:34 AM
• Tev.Holloman assigned the task to Tev.Holloman 1/8/2024 10:35:18 AM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name Broughton Hospital Maintenance Facility
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.* NCG01-2024-0035
Certificate of NCC240035
Coverage(COC)No.*
Invoice Date 1/5/2024
Initial Invoice No. NCC240035-2024
Initial Fee $ 120.00
Invoice Due Date 2/4/2024
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 1/8/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 727140956
Transaction Number*
NOI Tracking No. 176624
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-BURKE-2024-Broughton Hospital Maintenance Facility