| LCA CASE NUMBER | I-200-21182-440720 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-07-01 |
| DECISION DATE | 2021-07-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Medical Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | True |
| 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 | Jefferson Community Health Center |
| TRADE NAME DBA | Jefferson Community Health & Life |
| EMPLOYER ADDRESS1 | 2200 H Street |
| EMPLOYER CITY | Fairbury |
| EMPLOYER STATE | NE |
| EMPLOYER POSTAL CODE | 68352 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14027293351 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Bauer |
| EMPLOYER POC FIRST NAME | Sandra |
| EMPLOYER POC MIDDLE NAME | A |
| EMPLOYER POC JOB TITLE | Human Resources Director |
| EMPLOYER POC ADDRESS1 | 2200 H Street |
| EMPLOYER POC CITY | Fairbury |
| EMPLOYER POC STATE | NE |
| EMPLOYER POC POSTAL CODE | 68352 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14027293351 |
| EMPLOYER POC PHONE EXT | 4499 |
| EMPLOYER POC EMAIL | sandy.bauer@jchealthandlife.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Stockdale |
| AGENT ATTORNEY FIRST NAME | Kara |
| AGENT ATTORNEY MIDDLE NAME | Elizabeth |
| AGENT ATTORNEY ADDRESS1 | 1700 Farnam Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1500 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68102 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14023440500 |
| AGENT ATTORNEY EMAIL ADDRESS | kstockdale@bairdholm.com |
| LAWFIRM NAME BUSINESS NAME | Baird Holm LLP |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | NEBRASKA SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 2200 H Street |
| LCA CASE WORKLOC1 CITY | Fairbury |
| WORKSITE COUNTY | JEFFERSON |
| LCA CASE WORKLOC1 STATE | NE |
| WORKSITE POSTAL CODE | 68352 |
| LCA CASE WAGE RATE FROM | 25.5 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 22.95 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Stockdale |
| PREPARER FIRST NAME | Kara |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Baird Holm LLP |
| PREPARER EMAIL | kstockdale@bairdholm.com |
