| CASE NUMBER | I-200-23282-418650 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/9/2023 |
| DECISION DATE | 10/16/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physical Therapist |
| SOC CODE | 29-1123.00 |
| SOC TITLE | Physical Therapists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 2/1/2024 |
| END DATE | 1/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | W.A. Foote Memorial Hospital, Inc. |
| TRADE NAME DBA | Henry Ford Jackson Hospital |
| EMPLOYER ADDRESS1 | 205 N. East Ave. |
| EMPLOYER ADDRESS2 | N/A |
| EMPLOYER CITY | Jackson |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 49201 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | N/A |
| EMPLOYER PHONE | 15177884800 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Eagen |
| EMPLOYER POC FIRST NAME | Darcey |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Director, Human Resources |
| EMPLOYER POC ADDRESS1 | 205 N. East Avenue |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Jackson |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 49201 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15172057322 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | deagen1@hfhs.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Boyer |
| AGENT ATTORNEY FIRST NAME | Scott |
| AGENT ATTORNEY MIDDLE NAME | Jeffrey |
| AGENT ATTORNEY ADDRESS1 | 755 W. Big Beaver Road |
| AGENT ATTORNEY ADDRESS2 | Suite 1100 |
| AGENT ATTORNEY CITY | Troy |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48084 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12485199900 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | scott.boyer@ellisporter.com |
| LAWFIRM NAME BUSINESS NAME | Ellis Porter PLC |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | Michigan Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1201 E. Michigan Ave. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Jackson |
| WORKSITE COUNTY | JACKSON |
| WORKSITE STATE | MI |
| WORKSITE POSTAL CODE | 49201 |
| WAGE RATE OF PAY FROM | 101304 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $92,186.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 4 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-02 |
