| CASE NUMBER | I-200-24201-209245 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/19/2024 |
| DECISION DATE | 7/26/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Chief Technology Officer |
| SOC CODE | 11-3021.00 |
| SOC TITLE | Computer and Information Systems Managers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/23/2024 |
| END DATE | 9/22/2027 |
| 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 | Cabrillo Coastal General Insurance Agency, LLC. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 301 NW 138th Terrace |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Jonesville |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 32669 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13522242820 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524210 |
| EMPLOYER POC LAST NAME | McNitt |
| EMPLOYER POC FIRST NAME | Michael |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 301 NW 138th Terrace |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Jonesville |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 32669 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +13522242820 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | mmcnitt@cabgen.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Johnson |
| AGENT ATTORNEY FIRST NAME | William |
| AGENT ATTORNEY MIDDLE NAME | Joseph |
| AGENT ATTORNEY ADDRESS1 | 1295 Scott Street |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | San Diego |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92106 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16192696164 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | info@malitzlaw.com |
| LAWFIRM NAME BUSINESS NAME | Malitzlaw, Inc. |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court of New York |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 301 NW 138th Terrace |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Jonesville |
| WORKSITE COUNTY | ALACHUA |
| WORKSITE STATE | FL |
| WORKSITE POSTAL CODE | 32669 |
| WAGE RATE OF PAY FROM | 250,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $164,070.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| 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 | Johnson |
| PREPARER FIRST NAME | William |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Malitzlaw, Inc. |
| PREPARER EMAIL | info@malitzlaw.com |
| BEGIN DATE CONVERTED | 2025-11-09 |
