| LCA CASE NUMBER | I-200-20345-949967 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-12-10 |
| DECISION DATE | 2020-12-17 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | DEVELOPER |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-12-31 |
| END DATE | 2023-12-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | GREAT WEST LIFE & ANNUITY INSURANCE COMPANY |
| TRADE NAME DBA | EMPOWER RETIREMENT |
| EMPLOYER ADDRESS1 | 8525 EAST ORCHARD ROAD |
| EMPLOYER CITY | GREENWOOD VILLAGE |
| EMPLOYER STATE | CO |
| EMPLOYER POSTAL CODE | 80111 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13037354155 |
| NAICS CODE | 524210 |
| EMPLOYER POC LAST NAME | MEDARIS |
| EMPLOYER POC FIRST NAME | TONY |
| EMPLOYER POC JOB TITLE | SR. SPECIALIST, HR OPERATIONS SUPPORT TEAM |
| EMPLOYER POC ADDRESS 1 | 8515 EAST ORCHARD ROAD |
| EMPLOYER POC CITY | GREENWOOD VILLAGE |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 80111 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13037374155 |
| EMPLOYER POC EMAIL | TONY.MEDARIS@EMPOWER-RETIREMENT.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | OCHOA |
| AGENT ATTORNEY FIRST NAME | ANGELICA |
| AGENT ATTORNEY MIDDLE NAME | MARIA |
| AGENT ATTORNEY ADDRESS1 | 1125 17TH ST |
| AGENT ATTORNEY ADDRESS2 | SUITE 2400 |
| AGENT ATTORNEY CITY | DENVER |
| AGENT ATTORNEY STATE | CO |
| AGENT ATTORNEY POSTAL CODE | 80202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13032183669 |
| AGENT ATTORNEY EMAIL ADDRESS | aochoa@fisherphillips.com |
| LAWFIRM NAME BUSINESS NAME | FISHER & PHILLIPS LLP |
| STATE OF HIGHEST COURT | CO |
| NAME OF HIGHEST STATE COURT | COLORADO SUPPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 19 FOX STREET |
| LCA CASE WORKLOC1 CITY | WEST SPRINGFIELD |
| WORKSITE COUNTY | WEST SPRINGFIELD |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 1089 |
| LCA CASE WAGE RATE FROM | 123310 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 112466 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | BOHMAN |
| PREPARER FIRST NAME | KELLY |
| PREPARER BUSINESS NAME | FISHER & PHILLIPS LLP |
| PREPARER EMAIL | kbohman@fisherphillips.com |
