| CASE NUMBER | I-200-24319-474721 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/14/2024 |
| DECISION DATE | 11/21/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Software Engineer |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 2/21/2025 |
| END DATE | 2/20/2028 |
| 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 | OMS National Insurance Company |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 425 N. Martingale Road |
| EMPLOYER ADDRESS2 | Ste 900 |
| EMPLOYER CITY | Schaumburg |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 60173 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18473840041 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524210 |
| EMPLOYER POC LAST NAME | Zavala |
| EMPLOYER POC FIRST NAME | Aike |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Corporate Compliance Officer and VP of HR |
| EMPLOYER POC ADDRESS1 | 425 N. Martingale Road |
| EMPLOYER POC ADDRESS2 | Ste 900 |
| EMPLOYER POC CITY | Schaumburg |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 60173 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18473840041 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | aike.zavala@omsnic.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Travers |
| AGENT ATTORNEY FIRST NAME | Maura |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 2400 N Glenville Drive, Building A |
| AGENT ATTORNEY ADDRESS2 | Suite 100 |
| AGENT ATTORNEY CITY | Richardson |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 75082 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14699407883 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mtravers@bal.com |
| LAWFIRM NAME BUSINESS NAME | Berry Appleman and Leiden LLP |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Massachusetts Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 425 N. Martingale Road |
| WORKSITE ADDRESS2 | Ste 900 |
| WORKSITE CITY | Schaumburg |
| WORKSITE COUNTY | COOK |
| WORKSITE STATE | IL |
| WORKSITE POSTAL CODE | 60173 |
| WAGE RATE OF PAY FROM | $127,754.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $139,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $127,754.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| 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 | Vinjamoori |
| PREPARER FIRST NAME | Vasanthi |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Berry Appleman and Leiden LLP |
| PREPARER EMAIL | vvinjamoori@bal.com |
| BEGIN DATE CONVERTED | 2025-02-21 |
