WE ARE YouR DOL — 2 |e — ‘SWA Job Order #: Division of Immigrant Policies & Affairs: Foreign Labor Certification Unit: H-28 ‘SWA Job Order Form ‘Submit this form to H28@labor.ny.gov or fax it to (716) 541-9615. Call (585) 258-8858 or (716) 851-2609 with questions. Did you receive a Prev: ling Wage Determination for this H-28 job order? ONo Wes Employer Information: Employer/Business name; ATLONTIKOS LTD a County of Business: SUFFOLK Type of business: RESTAURANT. '¥ applicable, Doing Business As (DBA): LAST HOPE LAGOON Business address: 126 S EMERSON AVE city, MONTAUK. State: NY Zip code:11954 Maling address, i diferent: SHOLLYOAKAVENUE city: EASTHAMPTON state: NY Zip code.11937 Contact person: KIM PAPAS, Title: OWNER. E-Mail address: N/A Phone: 831-329-0471 Fax: NA Job Order information: +100 full ime, temporary and (check one): C] peak load Ml seasonal CJoneime occurrence [intermittent Dates of Need: From: 4/1/2020 _ To: 10/31/2020 Title of job opening: DINING ROOM ATTENDANTS Number of openings: 4 Worksite, if different from business address: N/A Daily ravel tofrom worksite provided: lll No] Yes: If yes, designated pickup location Education required: 0 Will on-the-job training (OJT) be provided? [MJNo [1] Yes Experience required: 1 fm Months [Years —Willyou accept atrainee? MJNo Yes Will ou accept related experience? No [1] Yes: If yes, please specify Work days: Ml Sun Ml Mon Ml Tues Ml Wed MiThurs Fri Sat Il Varies, Work hours: From: 7:00AM __ To: 10:00pm _Total hours per week: 40. Salary range: From: $14.10 _To:§1410__Per HOUR overtime offered? C]No Ml Yes: tyes, et what rate? 21.15 Pay day: FRIDAY Frequency of pay: Ml Weekly (J Bi-weekly’ Driver's License required: HINo [1] Yes: If yes, Class: Drug testing: MINo [Yes Benefits, Deductions & Allowances: All deductions trom the workers paycheck required by law will be mede. Applicable NYS Wage Order: (] Hospitality Industry [JMiscellaneous Industry Il N/A no additional deductions/ellowances Employer Provided Housing: ll No C] Yes: I yes, utilities paid by employer: C] No L Yes ‘Weekly deduction for housingjtilties, if applicable: FREE Employer Provided Meals: Ill No [1] Yes I yes, number/frequency of meals: per. Iyes, deduction per [] meal (] day ] week Employer Provided Uniforms: ll No L] Yes: If yes: Streetwear [] or L] Company Specifc®: Maintenance Amount _—_Iweek Any other employer provided benefits: Se Any other intended deductions: _Section 191 ofthe NYS Labor Law requires manual workers be paid no later than seven calendar days ater the end of the week in which wages were eared oer Section 195 of the NYS Labor Law, workers may not be charged for any company-specifc uniform. Per the NYS Miscellaneous and rospialty Minimum Wage Orders, f workers are required to maintain company specife uniforms, hey must be provided with arpuceble weekly maintenance amount. FL 515 (6/19) Page 1 of 3Job Description (Duties to be performed): Physical ability requirements (ex.: Lifting) Recruitment information: Candidates should (check all that apply): Contact employer directly via BX] Mail” [] Email] Fax L Telephone “Mall must be an option a5 there are job seekers who do not have access to small yen ne telephones, information ois 2PPY direct through the local Career Center ofthe State Workforce Agency (SWA), whose contact Ciormation i provided below. Please complete the nearest Career Genter Information wrichvenc oc yey by using the online Career Center Locator: htp:/labor.ny govicareer.center-locator! Local SWA Career Center name: Workforce New York Career Center Local SWA Career Center address: 160 South Ocean Avenue Patchogue, New York 11772, SSreerso9 Local SWA Career Center phone number 831-687-4800 Terms and Conditions/Clarifications and Assurances/Additional Information Torcnboyer must provide to an H-2B worker ouside ofthe U.S. no later than the time at which the worker apples for the va, or to a workerin any subsequent Soper eae tan on the day work commences, a copy ofthe ob oder i a language understood bythe worker, ctoang ‘any subsequent approved modifications. copia Pegen,ofgmpleymentspecifed onthe Applicaton for Temporary Employment Certification, the employer must comply with ell Tesco ciate and local employment-elated laws and regulations including heath and safety laws, Te inches Soon with 18 Recruitment Activities Fr aor rust Conduct recruitment of US, workers to ensure there ae no qualified U.S, workers who willbe avaiable forthe positions listed Incas a ae efemparary Employment Cetficaton, US, applicants can be reected only for awful job‘eatedreesore ion ace fom the date eee ce (CO) the employer must conduct the ecrutentdeseibedn G58 42 though G85.46 wan a sae oe rrutiae the Notice of Acceptance is isued. All employer-conducted recrutment must be completed beloe te stp er cae see Feawerentreport as required in 658.48. Employers must continue to accept referals and appicatons of US. aeploere gies one Position unti 21 days beloe the date of need, Fe ears nat wish to requie interviews must conduct those interviews by phone or provide a procedure for he interviews to be conducted in rote serene the worker is being recruited so that the worker incur tle or no cost. Employers cannot provide polorbal oS on hers ah job opponents Trarment with respec tothe requirement for, and conduct o, interviews, The employer must consider allUS.aopicentee Job opportunity. The employer must accept and hire any applicants who are qualifed and wno wil be evel FL 515 (6/19) Page 2 of 3re C0 abc maybe insructed by the CO to conduc atonal reasonable reeruiment. Such recrutment may be required at the eacretion of Meee tere te CO has determined there is alkelinood that U.S. workers who are qualied and wil be avatelne fore including but not limited to where the job opportunity is located in an Area of Substantial Unemployment Wage Ri 4 ind Deduct Trae wa9e in the jo order equals or exceeds the highest of he prevailing wage or Federal minimum wage, State minimum wage, or local Be Used To Soepute eenbYer Must pay at east the offered wage, fee and clear, dung the entire period ofthe contract A single weketo op bbe used to compute wages due, ‘ured san are workers Paycheck required by law willbe made. No deductons willbe made which reduce a worker's wages below the required rate In New York State, the only deductions that can be taken from worker pay are! 3. Those required by law, such as Social Security, income tax. and garnishment of wages: and 2. Those that benefit warkers and are authorized in writing, such as life insurance, ora savings account. Any other deductions are ilegal creer ne cciaton date Specified in the jb order, the services ofthe worker are no longer required for reasons beyond the convo ofthe Freire ue fre, weather, or other Act of God, or similar unforeseeable man-made catastrophic event (such as an sical ones the hours of oregch woriaveek inthe pay period: 2) the workers hourly rate andor piece rate of pay, (2) foreach workweek isthe Bay tented omoatocremponment offered tothe worker (4) for each workweek inthe pay period the Noursacuelly workeg by te Wenner (oye Cogan out Gaductons mage from or addons made othe worker's wages, (8) piece rates are uses. the Unies produced Gay 7) the beginning and ending dates of the pay period; and (8) the employers name, address and FEIN. ion, Subsist it Sep rores grees to reimburse inbound transportation and subsistence expenses ($12.46 per day minimum, without receipts, to a maximum of Srembtay ith feces) From the place from which the werker has come to work forte employer, whether inthe Us, or abvoad, te Ue rane deme yment ithe worker completes 60 percent of the period of employment covered by the job order (nat counting any enforcing) he Seermining the appropriate amount of reimbursement fr meals for less tan a full day, the employer may provie for meal omrence saa epeaton and subsistence directly, advance ata minimum the most economical and reasonable common carrer Gott f fe vantetions, {and subsistence to the worker before the worker's departure, or pay the worker forthe reasonable costs incurred by the worker '¥ applicable, employer will prove transportation, at no cost tothe worker, tothe actual work site and retum atthe end of the dey. Pamercs il be reimbursed inthe frst workweek forall visa, visa processing, border crossing, and other related fees, including those ‘mandated by the government (excluding passport fees). ‘Tools and Equipment ‘The employer will prove workers atno charge all tools, supplies, and equipment required to perform the job, Employer Signatur ne [an Date: 11/07/2019 FL 515 (6/19) Page 3 of 3(OMB Approval 1205-0508 Expraton Date 71312018 Application for Prevailing Wage Determination Form ETA9141 U.S. Department of Labor lease read and review the instructions carefully before completing found at hitp:/vinw foreianiaborcert doleta 19 this form and print legibly. A copy ofthe instructions can be ov! ‘A. Employment-Based Visa Information Indicate the typeof visa classification supported by this application (Whe clasiicaton symboy: * [x28 B. Requestor Point-of-Contact Information [1 Contacts tast (family) name = PAPAS 4 Contact job ttle * OWNER: 5 Address 1 6 HOLLYOAK AVENUE 6. Address 2 1 [First (Given) name™ 3 Middle name(s) ™ Kim 7 cy & Sia? 3, Postal code EAST HAMPTON NY 11937 70. Country = TI. Prove (applicable) United States Of America * 72. Telephone number™ 73, Extension ‘+1 (631) 329-0471 7. Enel Adaress USAMERICANS@AOL.COM 14, Fax Number ©. Employer Information 1. Legal business name* ATLONTIKOS LTD 2. ‘Trade name/Doing Business As (DBA), applicable § |LAST HOPE LAGOON ‘3 Address 1 6 HOLLYOAK AVENUE 4, Address 2 & ily 6 State™ 7, Postal cade * EAST HAMPTON NY 11937 ®. Country * 8. Province (if applicable) United States Of America 10. Telephone number = Ti. Extension +1 (631) 329-0471 12. Federal Employer identification Number (FEIN fom IRS) | 13. NAICS code (must be at ieast 4digits) ~ 72281 D. Wage Processing Information 11s the employer covered by ACWIA?™ DYes_GNo 2. Is the position covered by a Collective Bargaining Agreement (CBA)? = Yes @No 3.1 the employer requesting consideration of Davis-Bacon (DBA) or McNamara Service OYes @ No Contract (SCA) Acts? * OBA OScA For ETASTAI FOR DEPARTMENT OF LABOR USE ONLY Darr PW Tracking Number P0910 Cae Sits: Oem ses Validity Period. 85201 4q_souasz0(OMB Aprova: 1208-0506 Expiration Date: 713172018 Application for Prevailing Wage Determination Form ETA-0141 U.S. Department of Labor D. Wage Processing Information (cont) [41s the employer requesting consideration ofa survey in determining the prevaling wage?” ——[OYes No 4a,_Survey Name:§ 4b. Survey date of publication E. Job Offer Information a. Job Description: T. dob Title™ DINING ROOM ATTENDANTS: 2. Suggested SOC (ONETIOES) code* 2a. Suggested SOC (ONETIOES) occupation tle * 35-9011 Dining Room and Cafeteria Attendants and Bartender Helpers 3 Job Title of Supervisor for this Position (Fappicabie) § MANAGER ‘4. Does this position supervise the work of other employees? * “a. I Yes", number of employees worker § QYes @No | will supervise: 4b. if-Yes", please indicate the level of the employees to be supervised | _O Subordinate Gl Peer 5. Job duties ~ Please provide a description of the duties to be performed with as much specific as possible, nCuaing details regarding the areas/fields and/or products/industres involved. A description of the job duties to be performed MUST begin in this space. * CLEAN OFF & SET TABLES, BRING FOOD OUT TO BAR & TABLES, SERVE COFFEE/WATER ©. Will ravel be required in order to Ga. If*Yes", please provide details of the travel required, such as the area(s) perform the job duties? * frequency and nature of the travel. § Dyes _DNo Form ETASIAT FOR DEPARTMENT OF LABOR USE ONLY Pace bare PW Tracking Number. P-0081610%8022_ Cage Status: Sttnsenteved Validity Period 82018 gp 800000(OMe Approval 1208.0508 Expiration Date: 77972018 Application for Prevailing Wage Determination Form ETA-9141 U.S. Department of Labor E Job Offer Information (cont) b. Minimum Job Requirements: 1. Education: minimum U.S. diploma/degree required * None Ci High SchoolGED 0 Associate's Ci Bachelor's Ci Master's 1 Doctorate (PhD) (Other degree (JD, MD, etc,) ‘a. IfOther degree" in question 1, specify he diploma/ | 1b. Indicate the major(s) and/or field(s) of study required § 7 degree required § (May ist more than one related major and more than one field) NA 2. Does the employer require a second U.S. diplomaldegree? * Yes @No 2a. If"Yes" in question 2, indicate the second U.S. diploma/degree and the major(s) andlor feld(e) of study required § 3s training forthe job opportunity required? * QYes @No 3a. If"Yes" in question 3, specify the number of 3b. Indicate the field(s)iname(s) of training required § months of training required § (May ist more then one related feld and more than one type) 4__Is employment experience required? * ayes _ONo 4a, if*Yes" in question 4, speciy the number oF “4b. Indicate the occupation required § ‘months of experience required § 1 DINING ROOM ATTENDANT 5. Special Requirements - List specific skils, icenses/cerificates/oerifications, and requirements ofthe job opportunity. * NONE «. Place of Employment Information: 1, Warksiie address 1 126 S_ EMERSON AVENUE 2. Address 2 3 Giy™ 4. County MONTAUK Suffolk 5, State/DisticV Territory ™ &_ Postal code™ NY 11954 7. Will work be performed in multiple worksites within an area of intended vee employment or a location(s) other than the address listed above? * 7a. if"Yes", identity the geographic place(s) of employment indicating each metropolitan statistical area (SA) or the independent city(ies)/township(s)/county(ies) (borough(s)/parish(es)) and the corresponding state(s) where work will be Performed. If necessary, submit a second completed Form ETA-9141 witha listing of the additional anticipated worksites. Please note that wages cannot be provided for unspecified/unanticipated locations. § Form ETA-OTAT FOR DEPARTMENT OF LABOR USE ONLY Paces PW Tracking Number P0"81609089 Case Sats O86 Ione Validity Period. 282019 avamz0(OB Approvat 1205-0608 Expraton Date. 731/2019 Application for Prevailing Wage Determination Form ETA-9141 U.S. Department of Labor F. Prevailing Wage Determination FOR OFFICIAL GOVERNMENT USE ONLY 7 PW tacking number 2, Date PW request received 2 -400-19197-018623 onioaois 3, SOC (ONETIOES) cade 3a. SOG (ONETIOES) occupation tle 35.9011 Dining Room and Cafeteria Attendants and Bartender Helpers & Prevaling wage 4a. OES Wage level $14.08 oroon om ov ana 5. Per: (Choose only one) Hour_O Week O Bi-Weekly O Month Oi Year 0 Piece Rate ‘5a. If Piece Rate is indicated in question 5, specify the wage offer requirements = ©. Prevailing wage source (Choose only one) OES (All Industries) OES (ACWIA—Higher Education) GQ CBA Q DBA Q SCA 3 OtheriAltemate Survey 6a, If"Other/Aliemate Survey" in question 6, epeciy 7. Adalional Notes Regarding Wage Determination The Prevailing Wage Determination for the purposes of the H-2B program shall be the greater of the (1) actual wage level paid by the employer to other employees with similar experience and qualifications for such positions in the same location; or (2) the wage listed in Section F4 of the ETA Form 9141 &. Determination date 3. Expiration date 8/5/2019 6/30/2020 G._OMB Paperwork Reduction Act (1205-0508) Persons are not required to respond to ths collection of information unless it splays a currently valid OMB control number. Respondent's reply to these reporting requirements is mandatory to obtain the benefits of temporary employment certification (Immigration and Natonalty ‘Ad, Section 101). Public reporting burden for this colecion of information is estimated to average 55 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information, Send comments regarding this burden estimate to the Office of Foreign Labor Gerticaton = US. Deparmost ‘of Labor * Box 12 - 200 * 200 Consitution Ave., NW, “Washington, DC "20210, Do NOT send the completed application to thie, address, FOR DEPARTMENT OF LABOR USE ONLY Poon aere Fom ETAT cr td ‘Validity Period, 882018 PW Tracking Number PA0081.01823 Case Stats: 2Last Hope Lagoon 126 Emerson Avenue Montauk NY 11954 Tel: 631-329-0471 /Madam, This will confirm that I fully authorize U.S. Americans Inc to prepare and submit any and all applications and petitions required by the USDOL, Department of Homeland Security and the Department of State to approve the employment of temporary foreign workers for our company. This authorization is given to the following signatories of U.S. Americans In John Gismondi, V.P & Director of Operations, and John Gallo, President. We, along with U.S. American Ine, do not utilize any agent or recruiter for the recruitment of H-2B workers under this application for temporary employment certification. Our workers are referred to us by current employees in our company who have family and friends interested in working for us. We do not and will not receive payment of any kind from the workers for any activity related to obtaining H-2B labor certifications or employment, including payment of the employer’s agent or attorney fees, application and H-2B Petition fees, recruitment cost, or any fees attributed to obtaining the approved application for Employment Certification, This is to confirm that this occupation is not party to any collective bargaining agreement governing the job classification that is the subject of the H-2B labor certification application. Sincerely, Kim Papas Owneron. “ US AMERICANS 888 Baldwin Drive, Westbury NY 11590-1463 Tel: $16-997-1065/9187-fax. USDOL ‘Chicago NPC ‘Chicago, IL 60604 Dear Sir/Madam, ‘We at U.S. Americans Inc will not utilize any agent or recruiter for the recruitment of H-2B workers under this application for Temporary Employment certification. da ‘Gismondi Director of Operations(2a Asprovat 1205-2600 Expradon Date 0937/2022 H-2B Application for Temporary Employment Certification Form ETA 91428 ~ Appendix B U.S. Department of Labor For Use in Filing Applications Under the H-2B Non-Agricultural Program ONLY’ A. Attorney or Agent Declaration | hereby declare under penalty of pepury that | am an attomey forthe employer, or that | am an employe of.or hired by, the employer sted in ‘Section C ofthe Form ETA-9142B, and that | have been designated by that employer in accordance with 20 CFR 6888 lo act on ts behalf ‘Connection with tis apokction, as evdenced bythe attached agency agreement HEREBY CERTIFY that! have provided to the employer the Form ETA-G1428 and al supporting documentation for review and tothe best of ‘my kneedge the information contsined herein I true and accurate. including the emplayers decoration regarding actives | have uncertexen ‘on the employer's behalf in connection wi this application. | understand that to knowingly andi wilfuly tamsh malta false rformaion ih the preparation ofthis form and any supplement hereto orto aid, sbet. or counsel anather to do so i 8 federal offense punishable by fee, imprisonment, or both (18 USC. 2, 1007, 1546 1621). 1. Alomey or Agent's Last family) Name 7, First (given) Name™ 3 Midale inital § GISMONDI JOHN 4 Firm/Business Name ™ U.S. AMERICANS INC. @. Date Signed” aS (01/02/2020 B. Employer Declaration y vitue of my inils ad signature below, | HEREBY CERTIFY my knowledge of and compliance vith the folowing condions of employment applicable to H-28 workers andor U.S. workers who are hired curing the recntment penod for postions covered by ths application, cola ‘any approved extension thereat Initiats VA Too cpporuny «tun ie, ttn anor potion (tea! 95 hos pr wast, te culate and tequtemers for wich re constr whe oma and ace Gulfcabons ane reqarcmerts tepsed by nae reTe loys same comparable oszpators and aa ofskendcd employment. The cries has hse a clans rd reremerte nthe ob coer ——— 2 Theres no strike or lockout at any of the employer's worksites within the area of intended employment fr which the employer lef Is requesting an H-28 eerifeation. '3, The job opportunity wesis open to any qualified U.S. worker uni 21 days before the date of need regardless of race, calor, ational engin, age sex. reigion,dsabiy, or ciizenshp. U.S, workers who apply forthe job wil be Ried. uns the employer Ke ‘has @ lawful, job-elated reason(s) for the rejection, and the employer will retain records of al ejections. 4. The eplyer has nant ofr ams, wages, and wring contions to U.S workers hat are les invrbl than tase fered ew be oferedo 28 when or rgoe resins of obgabos an US wanes a sere ree on nS otters Ths does nt ekew te employe tm prowang 125 wartrs i tas re mnesers serets nage toting conatons tat ust be fee to U.S womer uae 20 CPR GSS 6 exc tr rane eho 36 SER Kv See Ta) pee ‘The offered wage equals or exceeds the highest ofthe applcable Federal, State, or local minimum wage, or the prevaling ‘wage determination for te occupation thats issued by the Department to the employer as reflected on ihe employers ‘approved Applicaton for Temporary Employment Certicaton, fr the time period the wok ls performed. I ater ihe esuance Of a prevaiing wage determination, the Department issues @ new or revised prevaling wage determination thal is sesigned to the employer's application or certified period of employment, te employer must ofer 8 wage that equals or exceeds the highest the new prevaing wage or the applicable Federal, State, or local minimum wage, unless nctfied otherwise by the Department. The employer will pay atleast the offered wage, fee and clear, ether in cash or in @ negcible irattument Payable at par. during the entre period of tis application. The employer must use a single workweek ays slandard for computing wages due, | The Deparment of Later Appropriations Act, 2076, Dvson H, Tie | of Public Lan 114-113 2016 DOL Appropriations Act), pyonoted the Decetment of Labor CBenartment) fom using any funds to enforce the defintion of camespording employment fund in 20 CFR 6553, or te toe fourth gosrartoe fle {eft found in 20 CFR 65820, or any reference thereto. Soo Sec. 113. This appropriations rider has been included ht the conrung salons Pat havo passes throughout FY 2017 and PY 2018, as wall asin he Depattrent of Labor Appropmatans Act 2018, OM H, Te of Puble Low tester (2018 DOL Appropriations Act). Therefore n order to comply the Department has remeved references to these provsons fm the Farm ETA-91420 ‘opens: 8. However, the 2016 DOL Arprpratons Act. Contnung resoliton, and 2018 DOL Approprisons Act Ge! net vaca Tse Teast ‘rovisions, and they remain in eflect thus imposing 2 legal duty on 1.28 employers even though the Department wl not use any Turd fo entree them Unt such tme asthe appropratans ndor may be ies Fom ETAST@2B~ Appendix Page BaF(OMB Approve 1205.0509 Exprodon Date: 0593/2022 H-28 Application for Temporary Employment Certfication Form ETA 91428 — Appendix 8 U.S. Department of Labor ‘The offered wage isnot based on commissions. bonuses or cher incentives, unles the employer quaantees a wage eamed every wertek that equals or exceeds the ofered wage. The employer guarantees to suppleme't apiece rate wage I at the dof the workweek. te piece rate doesnot result in average hourly lcce rate eamngs during the workweek at least equal 0 the ofered wage. Dutng the period of employment that isthe subject ofthis application, the employer wll comply vith applicable Federal, State {and local employment lated laws and regulations, including, but nl imited ta, employmentelated heath and safety lave, 20, CFR 655, Subpart A, 29 CFR 503, and all applicable provsions of the Far Labor Standards Acl. 28 U.S.C. 201 et seq, In Addition, the employer and is agents and atforeys afe prohbted ftom holding or confiscating workers” passports, woos, Or ‘other immigration documents pusuant to 18 U.S.C. 1892(a). ‘The employer has not laid of and wil not layoff any similarly employed U.S. werker inthe occupation and area of intended employment winin the period beginning 120 days before te date of need trough the end ofthe period of certhcalon, unless the layof is fr lal, job-related reasons and al H-28 workers are lai off rst ‘The employer and its agents, attoneys, and/or employees have not sought of received, and will not seek to receive, payment of any kind from the worker or any activity related to obtaining eriieaon or employment including, but nol lined to. payment of the employers attomey or agent fees, application or petion fees, or recrutmenk costs, Payment includes, but is hot ied to, monetary payments, wage concessions (including deductions from wages, salary, or benelifs).KeKbacks, bnbes, tibutes, ih kind paymerts, and tee labor. Upon the separation from employment of any H-28 or U.S. workers) employed under this application, i such separation ‘occurs prior tothe end date ofthe employment specified inthis application, the employer vl notty ihe Department in wring ot the separation ftom employment not later than two work days afer such separation Is dscovered by the employer The employer wil also noty DHS in wing or any other manner spestied by DHS) of such separation ofan H-2B worker ‘The employer wil not place any H.28 workers employed pursuant to this application outside the area of intended employment or na Job cassifcatio not Isted on the approved apelcation unless tne employer has obtained a new approved Form ETA e128, The employer has accurately represented its temporary need, as defined in 8 CFR 2142(%\(6)X6), including the number of Workers requested and dates of employment, on the Form ETA91428, job order. or an H-28 Regstation, es applcatle and been granted the H-28 Registration. unen applicable, ‘The employer wil make all deductions trom workers’ paychecks required by law and only those addtional authorized and easonable deductions daciosed in the job order. Deductions not disclosed vil be prohibed.Reasonableness of authorized ‘eductons is determined under the principles stated in 29 CFR 531. The vage payment requirement m conditons & and 6 of this Deciaration vill not be met where unauthorized or unreasonable deductions Seposi, rebates, or refunds reduce the wage payment below the offered wage or where the worker kicks back" any pat ofthe wages tothe empyer or another person for {he employer’ benef, ‘The employer has specifed in the job order any appicable minimum productivy standard which the workers must meet in lode to retain the job. With respect to any applicable productviy stander, the employer is abe to Gemonstate that such standard 's normal and usual for non-H.28 employers for he same occupation in the area of ntended employment. I, before the expiration date specified in the jb order, the services of a worker are no longer require for reasons beyond the Control of the employer due tote, weather or other Act of God, or similar unforeseeable man-made catastfophic event Ie femployer may terminate the job order with witten approval of the Certying Officer. and wil make eforts Yo taste the workers to comparable employment, orf ansfe is not effected, provide ru wranspetaton fr the worker a8 specified inthe regulations ‘The employer vill Keep a record of workers’ earnings and provide the wockers with eamings statements as requred by 20 CFR '855.20() on or before each payday, which must be at least every two weeks or accrding fo the prevaing practice in he area ot Intended employment, whichever is more Fequert. ‘The employer has dsclosed how i wil provide transportation and subsistence costs inthe jb order. The employe wil ether ‘advance all visa, visa-elated, border crossing, subsistence, and transportation expenses to wockers traveling tothe employers worksite ftom the workers’ place of recruitment, pay for them ctecly, or reimburse such expenses, olher than rave and subsistence, in the fst workweek and reimburse the remainder of the expenses no later than the time workers complete 50 Percent of the petiod covered by the job order. (Advancement of vansporiation and subsistence costs fo US. workers {employed under tis application is required when it's the prevaling practice of non H-28 employers inthe occupation inthe ‘area of intended employment or wien the employer extends such Benefits to similarly stuated H-25 workers), Provided tt ‘workers work unt the end of the cetiied period of employment o: are cismissed from employment for any reason before the fend of that period, the employer wil pay for such workers” retum transportation to the place of recutmert. and daly Subsistence the workers have no immediate subsequent H-28 employment. All employerprowied Wangportaton must comply wit al applicable Federal, Sale, and local lav and regulators, The employer wil provide to werkers, without charge or deposi all tools, supplies, and equipmert required to perform the dies assigned ‘The employer will prove a copy of the ob order to all H-28 werkers no later than when the worker apples fora visa located ‘broad, no later than the tme ofthe ob offer by the subsequent H-28 employer the H-28 workers changing employment fom (ne H-28 employer to a. subsequent H-2B employer and o US. werkers employed under tis application no later than onthe ‘day work commences. The disclosure must be in a language understood by the worker, as necessary or reasonable, STB Append PageB201BS(OMS Aporovat 1208-0508 ‘Exaroton Oat: 0901/2082 H-2B Application for Temporary Employment Certification Form ETA 81428 ~ Appendix B U.S. Department of Labor 20. The employer has posted a Department-provded poster detaiing H-2B and U.S. workers’ rights and protections in 8 conspicvous location at he place of employment. The employer will tequest and post addtional posters in languages common, to. signifcent portion of the workers iftey are not ent n English. 21. ‘The employer has not and wil not (and has not and vill not cause another person to) inkmidate, threaten restrain, coerce, blacklist, discharge, orn any other manner discriminate against any person who, wih respect to 8 U.S.C. 1184(¢), 20 GFR 655 Subpart A, 29 CFR 503, or any ther Department regulation promulgated thereunder, has fled complaint instilled or caused to be instituted any proceeding: testified ois abou to testy; consulted wth @ worker’ center, commmunly organization, labor ‘non, legal assistance program, or attomey, or exercised or asserted on bea of himselihersalf or others any rght oF protection. 22, The employer has and wll conrectually forbid in wring any agent or recriter (or any agent or employee of such agent of Fecruer) whom the employer engages, directly or indirectly in Irtematonal recrutment of H-28 workers fo seek or receive payments or other compensation from prospective workers. The employer and is atforey andior agent have prowded th this eppeaton tothe Department a copy of al agreements with ary agent or recrater whom it engages or plans to engage In the infemationa recutment of H-28 workers, as well asthe identity and location of al persons or erties red by or working for the agent or recruter, and any of thei agents or employees, to recrut prospective foreign workers for the H-25 joo ‘opportunites offered by the employer. 23. The employer wil conduct al required recrutment actives pursuant to 20 CFR 655.40 through 655.48 incuding but not. lited to: dationa recrutment if required by the Certfying Oficer and contacting all of ts former U.S. workers employed inthe ‘ccupaton at the place of employment during the previous yeer, dlsclosng he terms ofthe job oder, and slicing ther Tetum Lnless they were dismissed for cause o abandoned the worst 24. The employer has and wil continue to cooperate with the SWA by accepting referrals and vil hire all qualified and eligible U.S. workers who apply forthe job opportunty unt 21 days before the date of nes 25. The employer vill cooperate with any agent or employee ofthe Secretary of Labor whois exercising or attempting to exercise the Department's autnonty pursuant to 6 U.S.C. 1184(), including investigations as described in 29 GFR 503.25. 26, The employer wil retain all documents pertaining to this applcaion and registration, the recrutmentlated documents, the payroll records, and related documents for tree years as required by the reguations a 20 CFR 885 56 and 29 CFR 803.17 | hereby dosignate the agent or atomey identified in Secton E (f any) of the Form ETA-G1428 to represent me for the purpose of labor certification ane, by vitue of my signatue in Block below, | take fll esponsibility forthe accuracy of any representations. made by my agent ‘or atlomey on every page of he Form ETA-01428 and documentation supportng this aplication. | declare under penalty of perjury thet | have ead and reviewed ths apolcaton, including every page of the Form ETA.91428 and supporting land that othe best of my knowedge the formation contained hein ise and accurle.. Tundestand Tht fo ron MY ‘ancl ify furish mately fase information inthe preparation of his form ard any supplement thereto or toa abet, or Counsel anther i 301 a federal offense punishable by fre, mpisonment. or bth (18 U.S. 2,100, 146, 1821, Lappy Wane 2 FSR ane Swe TT liars Kin Te Cu A © Date Sgned™ = Saas Kune yew. 01/02/2020 Public Burden Statement (1205-0509) ASR RB RR Persons are not required to respond to this collection of information unless it aisplays @ currently valid OMB control ‘number. Public reporting burden for this collection of information is estimated to average 2 hours and 10 minutes to ‘Complete the form and its appendices, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the collection of information. The burden estimate is as follows: 9142B- 55 minutes, Appendix A- 15 minutes, Appendix B- 15 minutes, Appendix C- 20 minutes, ‘Appendix D- 10 minutes, and recorckeeping- 15 minutes. The obligation to respond to this data collection is required fo ‘obainvretain benefits (Immigration and Nationality Act, 8 U.S.C, 1101 et seq.). Please send comments regarding this ‘burden estimate or any other aspect ofthis information collection to the U.S. Department of Labor" Employment and ‘Training Administration * Office of Foreign Labor Certification * 200 Constitution Ave., NW" Box PPII 12-200 = Washington, DC * 20210 or by email to ETA.OFLC.Forms@dol gov. Please do not send the completed application to this address. Fom BTASTAIB~ Appendic Page of83