| LCA CASE NUMBER | I-200-21095-197863 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-04-05 |
| DECISION DATE | 2022-12-15 |
| ORIGINAL CERT DATE | 2021-04-12 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Scientist - Formulation Chemistry |
| SOC CODE | 19-2031.00 |
| SOC TITLE | Chemists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-19 |
| END DATE | 2024-09-18 |
| 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 | Provivi, Inc. |
| EMPLOYER ADDRESS1 | 1701 Colorado Ave. |
| EMPLOYER CITY | Santa Monica |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 90404 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13108282307 |
| NAICS CODE | 32532 |
| EMPLOYER POC LAST NAME | Baldwin |
| EMPLOYER POC FIRST NAME | Adam |
| EMPLOYER POC JOB TITLE | Director, People & Culture |
| EMPLOYER POC ADDRESS1 | 1701 Colorado Ave. |
| EMPLOYER POC CITY | Santa Monica |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 90404 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13108282307 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Grzegorek |
| AGENT ATTORNEY FIRST NAME | Kathleen |
| AGENT ATTORNEY MIDDLE NAME | Lynn |
| AGENT ATTORNEY ADDRESS1 | 707 Wilshire Boulevard |
| AGENT ATTORNEY ADDRESS2 | Suite 3200 |
| AGENT ATTORNEY CITY | Los Angeles |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90017 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12136278997 |
| AGENT ATTORNEY PHONE EXT | 185 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Stone Grzegorek & Gonzalez LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1701 Colorado Avenue |
| LCA CASE WORKLOC1 CITY | Santa Monica |
| WORKSITE COUNTY | LOS ANGELES |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 90404 |
| LCA CASE WAGE RATE FROM | 77792 |
| LCA CASE WAGE RATE TO | 85000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 77792 |
| 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 |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Grzegorek |
| PREPARER FIRST NAME | Kathleen |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Stone Grzegorek & Gonzalez LLP |
| PREPARER EMAIL | [email protected] |
