| LCA CASE NUMBER | I-200-21314-697524 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-10 |
| DECISION DATE | 2021-11-18 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Software Developer |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-11-29 |
| END DATE | 2024-11-28 |
| 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 | Derive LLC |
| EMPLOYER ADDRESS1 | 515 E Grant St |
| EMPLOYER ADDRESS2 | Suite 150 |
| EMPLOYER CITY | Phoenix |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 85004 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16027539990 |
| NAICS CODE | 541511 |
| EMPLOYER POC LAST NAME | Garcia |
| EMPLOYER POC FIRST NAME | Luis |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 515 E Grant St |
| EMPLOYER POC ADDRESS2 | Suite 150 |
| EMPLOYER POC CITY | Phoenix |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 85004 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16027539990 |
| EMPLOYER POC EMAIL | lgarcia@derivetalent.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Michailov |
| AGENT ATTORNEY FIRST NAME | Dimitar |
| AGENT ATTORNEY MIDDLE NAME | R. |
| AGENT ATTORNEY ADDRESS1 | 4350 East-West Highway |
| AGENT ATTORNEY ADDRESS2 | Suite 502 |
| AGENT ATTORNEY CITY | Bethesda |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 20814 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18888784721 |
| AGENT ATTORNEY EMAIL ADDRESS | dimo.michailov@cilawgroup.com |
| LAWFIRM NAME BUSINESS NAME | Capitol Immigration Law Group PLLC |
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | State of Mississippi |
| WORKSITE ADDRESS1 | 3771 Eastwood Dr |
| LCA CASE WORKLOC1 CITY | Jackson |
| WORKSITE COUNTY | HINDS |
| LCA CASE WORKLOC1 STATE | MS |
| WORKSITE POSTAL CODE | 39211 |
| LCA CASE WAGE RATE FROM | 95000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 89253 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Michailov |
| PREPARER FIRST NAME | Dimitar |
| PREPARER MIDDLE INITIAL | R |
| PREPARER BUSINESS NAME | Capitol Immigration Law Group PLLC |
| PREPARER EMAIL | dimo.michailov@cilawgroup.com |
