| LCA CASE NUMBER | I-200-21102-217077 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-12 |
| DECISION DATE | 2021-04-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Statistician |
| SOC CODE | 15-2041.00 |
| SOC TITLE | Statisticians |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Cleveland Asia Supermarket, Inc. |
| EMPLOYER ADDRESS1 | 21200 Miles Road |
| EMPLOYER CITY | North Randall |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44128 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12165181600 |
| NAICS CODE | 44511 |
| EMPLOYER POC LAST NAME | YANG |
| EMPLOYER POC FIRST NAME | Jay |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS 1 | 3781 Park Mill Run Drive |
| EMPLOYER POC CITY | Hilliard |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 43026 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16144427558 |
| EMPLOYER POC PHONE EXT | 17 |
| EMPLOYER POC EMAIL | jayyang@huaxin.us |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | JENSEN |
| AGENT ATTORNEY FIRST NAME | Peter |
| AGENT ATTORNEY MIDDLE NAME | Torben |
| AGENT ATTORNEY ADDRESS1 | 60 East 42nd Street |
| AGENT ATTORNEY ADDRESS2 | Suite 4600 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10165 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12127375800 |
| AGENT ATTORNEY EMAIL ADDRESS | contact@jensenlaw.com |
| LAWFIRM NAME BUSINESS NAME | The Jensen Law Firm PLLC |
|
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court, Appellate Division |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 21200 Miles Road |
| LCA CASE WORKLOC1 CITY | North Randall |
| WORKSITE COUNTY | CUYAHOGA |
| LCA CASE WORKLOC1 STATE | OH |
| WORKSITE POSTAL CODE | 44128 |
| LCA CASE WAGE RATE FROM | 31.48 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 31.48 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| 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 | JENSEN |
| PREPARER FIRST NAME | Peter |
| PREPARER MIDDLE INITIAL | T. |
| PREPARER BUSINESS NAME | The Jensen Law Firm PLLC |
| PREPARER EMAIL | contact@jensenlaw.com |
