| CASE NUMBER | I-203-23321-510824 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/17/2023 |
| DECISION DATE | 11/27/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | E-3 Austra |
| JOB TITLE | Operations Manager |
| SOC CODE | 39-9032.00 |
| SOC TITLE | Recreation Workers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/1/2024 |
| END DATE | 12/31/2025 |
| 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 | 20 Clarke Rd, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 70 Clark Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Thompson |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 18465 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18003992267 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 721214 |
| EMPLOYER POC LAST NAME | Gould |
| EMPLOYER POC FIRST NAME | Jeffrey |
| EMPLOYER POC MIDDLE NAME | Clark |
| EMPLOYER POC JOB TITLE | Director |
| EMPLOYER POC ADDRESS1 | 70 Clark Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Thompson |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 18465 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18003992267 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | jeff@independentlake.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | GRODE |
| AGENT ATTORNEY FIRST NAME | Jonathan |
| AGENT ATTORNEY MIDDLE NAME | Agins |
| AGENT ATTORNEY ADDRESS1 | 1524 Delancey Street |
| AGENT ATTORNEY ADDRESS2 | 4th Floor |
| AGENT ATTORNEY CITY | Philadelphia |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 19102 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12153958959 |
| AGENT ATTORNEY PHONE EXT | 0 |
| AGENT ATTORNEY EMAIL ADDRESS | jgrode@gands-us.com |
| LAWFIRM NAME BUSINESS NAME | Green and Spiegel, LLC |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Pennsylvania Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 70 Clark Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Thompson |
| WORKSITE COUNTY | SUSQUEHANNA |
| WORKSITE STATE | PA |
| WORKSITE POSTAL CODE | 18465 |
| WAGE RATE OF PAY FROM | 65000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $37,627.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| 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 | N/A |
| WILLFUL VIOLATOR | N/A |
| 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 | 2024-01-01 |
