| CASE NUMBER | I-200-24163-093814 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/10/2024 |
| DECISION DATE | 6/17/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Quality Engineer |
| SOC CODE | 17-2112.00 |
| SOC TITLE | Industrial Engineers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 8/13/2024 |
| END DATE | 8/12/2026 |
| TOTAL WORKER POSITIONS | 2 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 2 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Impact CNC, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2651 S 600 E |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Columbia City |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46725 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12602442919 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 332710 |
| EMPLOYER POC LAST NAME | Tauil |
| EMPLOYER POC FIRST NAME | Rafael |
| EMPLOYER POC MIDDLE NAME | E. |
| EMPLOYER POC JOB TITLE | Controller |
| EMPLOYER POC ADDRESS1 | 2651 S. 600 E |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Columbia City |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46725 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12602445511 |
| EMPLOYER POC PHONE EXT | 510 |
| EMPLOYER POC EMAIL | rtauil@impactcnc.net |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Guerrettaz |
| AGENT ATTORNEY FIRST NAME | David |
| AGENT ATTORNEY MIDDLE NAME | Anthony |
| AGENT ATTORNEY ADDRESS1 | 20 N.W. First Street |
| AGENT ATTORNEY ADDRESS2 | P.O. Box 916 |
| AGENT ATTORNEY CITY | Evansville |
| AGENT ATTORNEY STATE | IN |
| AGENT ATTORNEY POSTAL CODE | 47706 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18124247575 |
| AGENT ATTORNEY PHONE EXT | 207 |
| AGENT ATTORNEY EMAIL ADDRESS | dguerrettaz@zsws.com |
| LAWFIRM NAME BUSINESS NAME | Ziemer, Stayman, Weitzel & Shoulders, LLP |
| STATE OF HIGHEST COURT | IN |
| NAME OF HIGHEST STATE COURT | Indiana Supreme Court |
| WORKSITE WORKERS | 2 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2651 S. 600 E. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Columbia City |
| WORKSITE COUNTY | WHITLEY |
| WORKSITE STATE | IN |
| WORKSITE POSTAL CODE | 46725 |
| WAGE RATE OF PAY FROM | 65000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $60,091.00 |
| PW UNIT OF PAY | Year |
| 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 | 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 | 2025-01-08 |
