| CASE NUMBER | I-200-24121-941249 |
| CASE STATUS | Certified |
| RECEIVED DATE | 4/30/2024 |
| DECISION DATE | 5/7/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Software Engineer III |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 5/13/2024 |
| END DATE | 5/12/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Capital Blue Cross |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 2500 Elmerton Avenue |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Harrisburg |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 17177 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17175416268 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Weigand |
| EMPLOYER POC FIRST NAME | Eryn |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Director, Talent Acquisition |
| EMPLOYER POC ADDRESS1 | 2500 Elmerton Avenue |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Harrisburg |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 17177 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17175416266 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Eryn.Weigand@CapBlueCross.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Kembel |
| AGENT ATTORNEY FIRST NAME | Kendra |
| AGENT ATTORNEY MIDDLE NAME | S |
| AGENT ATTORNEY ADDRESS1 | 2215 Millennium Way |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Enola |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 17025 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 17175065207 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | jillian.cuervo@immigrationsupport.com |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Kendra S. Kembel, Esq. |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Pennsylvania |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3904 Donna Jane Ct |
| WORKSITE ADDRESS2 | Apt A108 |
| WORKSITE CITY | Harrisburg |
| WORKSITE COUNTY | DAUPHIN |
| WORKSITE STATE | PA |
| WORKSITE POSTAL CODE | 17109 |
| WAGE RATE OF PAY FROM | 90522 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $116,400.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $90,522.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | 2025-01-05 |
