| LCA CASE NUMBER | I-200-21082-167965 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-23 |
| DECISION DATE | 2021-03-30 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Lead Developer Mobile |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-19 |
| END DATE | 2024-08-18 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY |
| TRADE NAME DBA | Empower Retirement |
| EMPLOYER ADDRESS1 | 8515 E ORCHARD ROAD |
| EMPLOYER ADDRESS2 | 3T2 |
| EMPLOYER CITY | Greenwood Village |
| EMPLOYER STATE | CO |
| EMPLOYER POSTAL CODE | 80111 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13037372808 |
| NAICS CODE | 524113 |
| EMPLOYER POC LAST NAME | Medaris |
| EMPLOYER POC FIRST NAME | Tony |
| EMPLOYER POC JOB TITLE | Senior Specialist, HR Operations Support Team |
| EMPLOYER POC ADDRESS 1 | 8515 E Orchard Road |
| EMPLOYER POC ADDRESS 2 | 3T2 |
| EMPLOYER POC CITY | Greenwood Village |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 80111 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13037372449 |
| EMPLOYER POC EMAIL | tony.medaris@empower-retirement.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Behm |
| AGENT ATTORNEY FIRST NAME | Jennifer |
| AGENT ATTORNEY ADDRESS1 | 2300 Wehrle Dr |
| AGENT ATTORNEY CITY | Buffalo |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 14221 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17166341010 |
| AGENT ATTORNEY EMAIL ADDRESS | jebehm@usimmlawyer.com |
| LAWFIRM NAME BUSINESS NAME | Berardi Immigration Law |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NY Court of Appeals 4th Dept |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 100 Federal Street |
| LCA CASE WORKLOC1 CITY | Boston |
| WORKSITE COUNTY | BOSTON CITY |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 2110 |
| LCA CASE WAGE RATE FROM | 139885.2 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 135658 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Edlich |
| PREPARER FIRST NAME | Samantha |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Berardi Immigration Law |
| PREPARER EMAIL | sedlich@usimmlawyer.com |