| LCA CASE NUMBER | I-200-21033-049863 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-02-02 |
| DECISION DATE | 2021-02-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | SENIOR SOFTWARE ENGINEER |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-24 |
| END DATE | 2024-07-23 |
| 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 | WORKERS' COMPENSATION INSURANCE RATING BUREAU OF CALIFORNIA |
| EMPLOYER ADDRESS1 | 1221 BROADWAY STREET |
| EMPLOYER ADDRESS2 | SUITE 900 |
| EMPLOYER CITY | OAKLAND |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94612 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14157787024 |
| NAICS CODE | 52429 |
| EMPLOYER POC LAST NAME | DERRINGER |
| EMPLOYER POC FIRST NAME | HARLEN |
| EMPLOYER POC JOB TITLE | MANAGING DIRECTOR, HUMAN RESOURCES |
| EMPLOYER POC ADDRESS 1 | 1221 BROADWAY |
| EMPLOYER POC ADDRESS 2 | SUITE 900 |
| EMPLOYER POC CITY | OAKLAND |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94612 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14157787024 |
| EMPLOYER POC EMAIL | HDERRINGER@WCIRB.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 | 1221 BROADWAY STREET |
| WORKSITE ADDRESS2 | SUITE 900 |
| LCA CASE WORKLOC1 CITY | OAKLAND |
| WORKSITE COUNTY | ALAMEDA |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 94612 |
| LCA CASE WAGE RATE FROM | 145246 |
| LCA CASE WAGE RATE TO | 155386 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 145246 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| 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 | BAHNAN C#5521357 |
| PREPARER FIRST NAME | NADINE |
| PREPARER MIDDLE INITIAL | K |
| PREPARER BUSINESS NAME | FRAGOMEN, DEL REY, BERNSEN & LOEWY, LLP |
| PREPARER EMAIL | NBAHNAN@FRAGOMEN.COM |