| CASE NUMBER | I-200-24178-151188 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/26/2024 |
| DECISION DATE | 7/3/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | EDI Developer |
| SOC CODE | 15-1299.08 |
| SOC TITLE | Computer Systems Engineers/Architects |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| 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 | Community Health Center Network |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 101 Callan Avenue |
| EMPLOYER ADDRESS2 | Suite 300 |
| EMPLOYER CITY | San Leandro |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94557 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15102970244 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | Ibarra de Perea |
| EMPLOYER POC FIRST NAME | Michael |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Administrative Officer |
| EMPLOYER POC ADDRESS1 | 101 Callan Avenue |
| EMPLOYER POC ADDRESS2 | Suite 300 |
| EMPLOYER POC CITY | San Leandro |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94577 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15102970244 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | mperea@chcnetwork.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Gibson |
| AGENT ATTORNEY FIRST NAME | Lauren |
| AGENT ATTORNEY MIDDLE NAME | Beth |
| AGENT ATTORNEY ADDRESS1 | 360 Post Street |
| AGENT ATTORNEY ADDRESS2 | Suite 800 |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94108 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14159813000 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | lgib@vblaw.com |
| LAWFIRM NAME BUSINESS NAME | Van Der Hout LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | California Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 101 Callan Avenue |
| WORKSITE ADDRESS2 | Suite 300 |
| WORKSITE CITY | San Leandro |
| WORKSITE COUNTY | ALAMEDA |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 94577 |
| WAGE RATE OF PAY FROM | 115,066.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $115,066.00 |
| 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 | Tennekoon |
| PREPARER FIRST NAME | Lily |
| PREPARER MIDDLE INITIAL | V |
| PREPARER BUSINESS NAME | Van Der Hout LLP |
| PREPARER EMAIL | lken@vblaw.com |
| BEGIN DATE CONVERTED | 2024-01-10 |
