| LCA CASE NUMBER | I-200-20307-894544 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-11-02 |
| DECISION DATE | 2020-11-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | MGR, FP&A and Business Operations |
| SOC CODE | 13-2051.00 |
| SOC TITLE | Financial Analysts |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-11-06 |
| END DATE | 2023-11-05 |
| 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 | Form Energy, Inc. |
| EMPLOYER ADDRESS1 | 30 dane Street |
| EMPLOYER CITY | Somerville |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 2143 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14123028414 |
| NAICS CODE | 335999 |
| EMPLOYER POC LAST NAME | Wiley |
| EMPLOYER POC FIRST NAME | Ted |
| EMPLOYER POC JOB TITLE | Chief Operating Officer |
| EMPLOYER POC ADDRESS 1 | 30 Dane Street |
| EMPLOYER POC CITY | Somerville |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 02143 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14123028414 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Hauer |
| AGENT ATTORNEY FIRST NAME | Douglas |
| AGENT ATTORNEY ADDRESS1 | One Financial Center |
| AGENT ATTORNEY CITY | Boston |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 2111 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16173484976 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Mintz |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 30 Dane Street |
| LCA CASE WORKLOC1 CITY | Somerville |
| WORKSITE COUNTY | SOMERVILLE CITY |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 2143 |
| LCA CASE WAGE RATE FROM | 170000 |
| LCA CASE WAGE RATE TO | 190000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 135422 |
| PW UNIT OF PAY | Year |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2020 |
| PW SURVEY PUBLISHER | Mercer LLC |
| PW SURVEY NAME | US MBD/TRS Mercer Finance/Accounting/Legal Survey |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Estes |
| PREPARER FIRST NAME | John |
| PREPARER BUSINESS NAME | Mintz |
| PREPARER EMAIL | [email protected] |
