| CASE NUMBER | I-200-24093-849093 |
| CASE STATUS | Certified |
| RECEIVED DATE | 4/2/2024 |
| DECISION DATE | 4/9/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Health Informatics Data Analyst |
| SOC CODE | 15-2051.02 |
| SOC TITLE | Clinical Data Managers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Community Clinic of Maui, Inc. |
| TRADE NAME DBA | Malama I Ke Ola Health Center |
| EMPLOYER ADDRESS1 | 1881 Nani Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Wailuku |
| EMPLOYER STATE | HI |
| EMPLOYER POSTAL CODE | 96793 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18088717772 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | van der Aa |
| EMPLOYER POC FIRST NAME | Monique |
| EMPLOYER POC MIDDLE NAME | Elisabeth Maria |
| EMPLOYER POC JOB TITLE | Chief Financial Officer |
| EMPLOYER POC ADDRESS1 | 1881 Nani Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Wailuku |
| EMPLOYER POC STATE | HI |
| EMPLOYER POC POSTAL CODE | 96793 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18088724017 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | monique@ccmaui.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Cook |
| AGENT ATTORNEY FIRST NAME | Vaughn |
| AGENT ATTORNEY MIDDLE NAME | Graham Takao |
| AGENT ATTORNEY ADDRESS1 | 120 Pauahi Street |
| AGENT ATTORNEY ADDRESS2 | Suite 312 |
| AGENT ATTORNEY CITY | Hilo |
| AGENT ATTORNEY STATE | HI |
| AGENT ATTORNEY POSTAL CODE | 96720 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18089610406 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | vgc@torkildson.com |
| LAWFIRM NAME BUSINESS NAME | Torkildson Katz, A Law Corporation |
| STATE OF HIGHEST COURT | HI |
| NAME OF HIGHEST STATE COURT | Hawaii Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1881 Nani Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Wailuku |
| WORKSITE COUNTY | MAUI |
| WORKSITE STATE | HI |
| WORKSITE POSTAL CODE | 96793 |
| WAGE RATE OF PAY FROM | 51397 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $75,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $51,397.00 |
| 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 | Cook |
| PREPARER FIRST NAME | Vaughn |
| PREPARER MIDDLE INITIAL | G |
| PREPARER BUSINESS NAME | Torkildson Katz, A Law Corporation |
| PREPARER EMAIL | vgc@torkildson.com |
| BEGIN DATE CONVERTED | 2024-01-10 |
