| CASE NUMBER | I-200-24181-162686 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/29/2024 |
| DECISION DATE | 7/8/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Business Intelligence Developer II |
| SOC CODE | 15-2051.01 |
| SOC TITLE | Business Intelligence Analysts |
| FULL TIME POSITION | Y |
| BEGIN DATE | 11/1/2024 |
| END DATE | 10/31/2027 |
| 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 | Jewelers Mutual Insurance Company, SI |
| TRADE NAME DBA | Jewelers Mutual Group |
| EMPLOYER ADDRESS1 | 24 Jewelers Park Drive |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Neenah |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 54956 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +19205212340 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524126 |
| EMPLOYER POC LAST NAME | Masanz |
| EMPLOYER POC FIRST NAME | Anastacia |
| EMPLOYER POC MIDDLE NAME | Marie |
| EMPLOYER POC JOB TITLE | Senior HR Business Partner |
| EMPLOYER POC ADDRESS1 | 24 Jewelers Park Drive |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Neenah |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 54956 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +19205212340 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | smasanz@jminsure.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Santa Maria |
| AGENT ATTORNEY FIRST NAME | Monica |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 354 W. Main St. |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Madison |
| AGENT ATTORNEY STATE | WI |
| AGENT ATTORNEY POSTAL CODE | 53703 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16082573152 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | admin@santamaria-legal.com |
| LAWFIRM NAME BUSINESS NAME | Santa Maria Law Office, LLC |
| STATE OF HIGHEST COURT | WI |
| NAME OF HIGHEST STATE COURT | Supreme Court of Wisconsin |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 5910 North Central Expressway |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Dallas |
| WORKSITE COUNTY | DALLAS |
| WORKSITE STATE | TX |
| WORKSITE POSTAL CODE | 75206 |
| WAGE RATE OF PAY FROM | 130,270.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $130,270.00 |
| 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 | 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-11 |
