| LCA CASE NUMBER | I-200-21264-597578 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-09-21 |
| DECISION DATE | 2023-07-17 |
| ORIGINAL CERT DATE | 2021-09-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Salesforce QA Engineer |
| SOC CODE | 15-1199.01 |
| SOC TITLE | Software Quality Assurance Engineers and Testers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-04 |
| END DATE | 2024-10-03 |
| 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 | CLOVER HEALTH LABS, LLC. |
| EMPLOYER ADDRESS1 | 30 MONTGOMERY STREET |
| EMPLOYER ADDRESS2 | 15TH FLOOR |
| EMPLOYER CITY | JERSEY CITY |
| EMPLOYER STATE | NJ |
| EMPLOYER POSTAL CODE | 07302 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18887781478 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Zorio |
| EMPLOYER POC FIRST NAME | Tim |
| EMPLOYER POC JOB TITLE | Senior Human Resources Business Partner |
| EMPLOYER POC ADDRESS1 | 30 MONTGOMERY STREET |
| EMPLOYER POC ADDRESS2 | 15TH FLOOR |
| EMPLOYER POC CITY | JERSEY CITY |
| EMPLOYER POC STATE | NJ |
| EMPLOYER POC POSTAL CODE | 07302 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18887781478 |
| EMPLOYER POC EMAIL | tim.zorio@cloverhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | BAHNAN |
| AGENT ATTORNEY FIRST NAME | NADINE |
| AGENT ATTORNEY MIDDLE NAME | KHAMIS |
| AGENT ATTORNEY ADDRESS1 | 555 MONTGOMERY STREET |
| AGENT ATTORNEY ADDRESS2 | 4TH FLOOR |
| AGENT ATTORNEY CITY | SAN FRANCISCO |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94111 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14159861446 |
| AGENT ATTORNEY EMAIL ADDRESS | NBAHNAN@FRAGOMEN.COM |
| LAWFIRM NAME BUSINESS NAME | FRAGOMEN, DEL REY, BERNSEN & LOEWY, LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 7525 Tree Lane |
| WORKSITE ADDRESS2 | Apt 202H |
| LCA CASE WORKLOC1 CITY | Madison |
| WORKSITE COUNTY | DANE |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 53717 |
| LCA CASE WAGE RATE FROM | 123000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 100714 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| 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 | BAHNAN C#5991720 |
| PREPARER FIRST NAME | NADINE |
| PREPARER MIDDLE INITIAL | K |
| PREPARER BUSINESS NAME | FRAGOMEN, DEL REY, BERNSEN & LOEWY, LLP |
| PREPARER EMAIL | NBAHNAN@FRAGOMEN.COM |