| CASE NUMBER | I-200-24095-856548 |
| CASE STATUS | Certified |
| RECEIVED DATE | 4/4/2024 |
| DECISION DATE | 4/11/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Quality Control Chemist |
| SOC CODE | 19-2031.00 |
| SOC TITLE | Chemists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| 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 | Excelsior Nutrition Inc. |
| TRADE NAME DBA | 4Excelsior |
| EMPLOYER ADDRESS1 | 1206 N. Miller Street |
| EMPLOYER ADDRESS2 | Suite D |
| EMPLOYER CITY | Anaheim |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 92806 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16579995188 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 325411 |
| EMPLOYER POC LAST NAME | Wu |
| EMPLOYER POC FIRST NAME | Jian |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Financial Officer |
| EMPLOYER POC ADDRESS1 | 1206 N. Miller Street |
| EMPLOYER POC ADDRESS2 | Suite D |
| EMPLOYER POC CITY | Anaheim |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 92806 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16579995188 |
| EMPLOYER POC PHONE EXT | 1549 |
| EMPLOYER POC EMAIL | jw@4excelsior.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Hu |
| AGENT ATTORNEY FIRST NAME | Xiaomin |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 2070 Business Center Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 205 |
| AGENT ATTORNEY CITY | Irvine |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92612 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 19495020873 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | xhu@huimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of Xiaomin Hu, P.C. |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme Court of Florida |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1206 N. Miller Street |
| WORKSITE ADDRESS2 | Suite D |
| WORKSITE CITY | Anaheim |
| WORKSITE COUNTY | ORANGE |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 92806 |
| WAGE RATE OF PAY FROM | 26 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $25.56 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| 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 | Yes |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | Yes |
| STATUTORY BASIS | Masters Degree or higher in related specialty |
| APPENDIX A ATTACHED | Yes |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-10 |
