| CASE NUMBER | I-200-24030-677952 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/30/2024 |
| DECISION DATE | 2/6/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Neonatologist |
| SOC CODE | 29-1221.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/7/2024 |
| END DATE | 7/6/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Covenant Medical Center, Inc. |
| TRADE NAME DBA | MercyOne Waterloo Medical Center |
| EMPLOYER ADDRESS1 | 3421 W. 9th Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Waterloo |
| EMPLOYER STATE | IA |
| EMPLOYER POSTAL CODE | 50702 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 13192728000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Huber |
| EMPLOYER POC FIRST NAME | Timothy |
| EMPLOYER POC MIDDLE NAME | J. |
| EMPLOYER POC JOB TITLE | Chief Financial Officer |
| EMPLOYER POC ADDRESS1 | 3421 W. 9th Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Waterloo |
| EMPLOYER POC STATE | IA |
| EMPLOYER POC POSTAL CODE | 50702 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 13192727607 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | tim.huber@mercyhealth.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Fortier |
| AGENT ATTORNEY FIRST NAME | Kelly |
| AGENT ATTORNEY MIDDLE NAME | M. |
| AGENT ATTORNEY ADDRESS1 | 790 N. Water Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Milwaukee |
| AGENT ATTORNEY STATE | WI |
| AGENT ATTORNEY POSTAL CODE | 53202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14142716560 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | jlzuba@michaelbest.com |
| LAWFIRM NAME BUSINESS NAME | Michael Best & Friedrich LLP |
| STATE OF HIGHEST COURT | WI |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3421 W. 9th Street |
| WORKSITE ADDRESS2 | MercyOne Waterloo Medical Center |
| WORKSITE CITY | Waterloo |
| WORKSITE COUNTY | BLACK HAWK |
| WORKSITE STATE | IA |
| WORKSITE POSTAL CODE | 50702 |
| WAGE RATE OF PAY FROM | 343400 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $241,155.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Zuba |
| PREPARER FIRST NAME | Jessica |
| PREPARER MIDDLE INITIAL | L. |
| PREPARER BUSINESS NAME | Michael Best & Friedrich LLP |
| PREPARER EMAIL | jlzuba@michaelbest.com |
| BEGIN DATE CONVERTED | 2024-07-07 |
