U.S. Department LaborEmployment and Training Administration

OMB Conkol No. 1205.0'134

Expiration Datei December 31, 2018

Agricultural and Food Processinq Clearance Order ETA Form 790Orden de Empleo para Obreros/Trabaiadores Agricolas y Procesamiento de Alimentos

(Print or type in esch field block - To include additional informatlon, go to block # 2E - Please follow Stsp.By.Step lnstructions)(Favor de usar letra de molde en la solicilud - Para incluir informaci6n adicional vea el punto # 28 - Favor de seguir las instrucciones paso.a.paso)

1, Employels and/or Agent s NameandAddress (Number, Streel, Cily, I

and Zip Code / Nombre y Dlreccion del Empleadori Palr6n y/o Agente(Ntmero, Calle, Ciudad, Estado y C6digo Postal ):

Nerr\.(^ Ke.\ l-l "^^ 5\^r\ ) JFr' C

3ts r.r F.+dy N:,.q* (\'[!+ 5.-r.".^t I AJ Y \r) Y \

a) Federal Employer ldentification Number (FEIN) / N0mero federaldeldentif icacidn del Empleador:

\\- 1)'?\J G 6b) Telephone Number / N0mero de Tel6fonoi

G)\^SB't-t3:)\c) Fax Number / Nimero de Fax:

G3\-xba-g.l\Gd) E-mail Address / Direcci6n de Correo Electr6nim:

l.Jur,,.q,r o( fr r r,t'.r.lkc.\ N-.r..!qa\.J . Ci,:.1

Code / Codigo lnduslriall

a. SOC (ONET/oES) OccupationalTille / Tltulo Ocupacional

5,Job Order No. / Num. de orden de

6. Address of 0rder Hold ng oflice (include Telephone number) / Direccion dela Oficira dond€ se radico la oferta (incluya el n[mero de tel6fono);

a. Name of Local ofiice Representative (include direct dial telephonenumber) / Nombre del Represenlante de la oficina Local (lncluya elntmero de telefono de su linea direcla).

2. Address and Directions to Work Siie / Domlcilio y D recciones al lugar de

/-\ trabajor 3< ,+ r:. \ r-7 {\r-r,-rulL\E i. F<-l. S] r.r.. r-,r

\-.Yc- ^SO \- \--.r6wr,{ Ovt*

u<\\ r r L*J 6,*'vrr J \- \:.\\) or.rr c- fl.\

uui\Y.\.-\.'<-- s+.r, *\ +- t,tt.\tst I Li

r.af irJ os+ rt.rr.- Rr q1w'pt" ytrr-

N\r $.*sp "+-\1-7 rr?8$

Date / Fecha de Emisi6n de la Orden de

de Vencimienlo o Expiraci6n de la Orden

Anticipated Period of Employmeni / Periodo anticlpado o previsto

From / Desde: 7ltgltT To/Hasta. ille"l17

3. Address and Directions io Housing / Qomicilio y

vivienda: (.-pc .\ \ I ftlg -+ \'L\ N '+'-\ '"^'*1 ft\,/o-- 3 Ast w\rr. ^.i ft\ , 1..*"r-r ,

c.r..p *-!a \7 / g

a) Oesciptio'n of Uousing'/ Oescripci6n de la viviendai

' Hltytr-S q.r.- \u-rt7 \ u.ro...r\.{-\

\-,, .+\ !,".'.t!1.- lq!\-\,-: 1 ! tr...-.$:rr..i .l ^.i \ , \lR- <j-r.-- \-,l.f,.J \-

\...:+ .^.\ V-.s)

5- So"*---]

^r.t -7b\

e Y u{x$

'11. Anticipated Hours oi Work per Week / Horas Anticipadas/Previstas deTrabajo por Semana, Totali !i d

Sunday i Domingo_ Thursday /Jueves_Mondav / Lunes d Fridav , Viernes Ktresda'y / ManesT- saturiav I saoiii]S-wednejoay / vtarcilL

12. Antic pated range of hours for differenl seasonal activities / Rafgo previsto dehoras par alas diferentes aclivldades de la lernporada:

\,-' \\r\ ) ^ -) c."'r - 3.)t ?'^13. Collect Calls Accepted from: / Aceptan Llamadas por Cobrar de:

ves i sfl r,ro o

Nos.4 through 8 for STATE USE ONLYN0meros 4 a 8 para USO ESTATAL

10. Number ol Workers Requested / Nimero de Trabajadores Solicitados:

)c

45209200

Farmworkers & Laborers CropNursery & Greenhouses

877-466-9757

877-466-9757

12/6/2018

7/10/2019

Total capacity: 2812/6/18 RC

Received 12/6/18RC

NY1285291

14,DescribehowlheemployerifltendSloproV]dee]lher3mealsadayloeachworkemeals / oescriba como elempleador tiene la intenci6n de ofrecer, ya sea 3 comidas aldia a cada trabajador, o propo rcionar gratuitamente instalaciones para cocinar.

Et^p\o-1 ,r. r.,r'.\\, fro.,.\<- R\! (.,o!.-.^) rtt(ss)r\ro--.r \AQr,Vr-..^1 \.,.t\ o-: g t\-\ ?*:t {"n-v-.-r, knrv.-r I Sf .rr"3

(t.'r-p\ +- q\^,\u). \\""^t1 r.rr-..\ h^uu out_n.l; S{e"rt-.t,

t <-\c.l pe ,--\rI ,fs P r,'<-P-e{- /Yv\ q-.^.1r

F^pto+-.- \r-\\ \-|r--\^ 5p "F. +- N gfkr..) oN( \ o\- c,.., t lk

\o \r.r r.7 SLa-t"- {=, f.rt<A"*se- S," N

-2-

and/or other accidentals

12/6/18RC

Employer s/Agenls available tiour to interview workerc / Explique como los canoioatos se,an-coniatJ*'. ili.iio.r, vl!! irr,;;;r"bdi;;ii;lrs.ni" p",entrevislar a los trabajadores). See instructions for more details / Vea las instrucciones para m6s detalles.

fo-'.\ 1y1 u1r'.cr. kc--\ c^-l t"3r- SE\- G33:--\.n- \,.. '.1\+cp Q+-,."t{.1\,n Slr.r.q-\r r,'. \ s( c,rr-\c^\_\

6!!- Ll?- \Lb - \f Sl

\\ . -. > \" r,-- q r.. \lr-,-.rt \,^j 5

\l^q-_ n<".C" S {- b,i.._

Cr.ce* \t-\- *€ \ r-dqN tc u-r

(\) ort...,* Ko,- \ +- c,.qp \r, (*,.\-

$.,.-+ I \.-\ , r-\ <-.,-,. - * ) I * *k-r..^ ) \* p'<p *-A rzr 5 \ r',\"r*.^J \ t*"7Qoi\r-.}l f\"."'\ \ L(\- S "..*- \n\ \r!(,-\ \o r,** r S\"r-..J.-- 1 o,r \< <_\

d,\ c- r \ n\q;\ Vs*5. )b c..,-'1 \<-.:+ \rs.<',r PaS\- k.r<- o'Ar qi\ProYL r: ("\os'"\ (--

1. ls previous workrexpeaence preferred? /Se prefiere previa experiencia? Yes/SF-.NoO lfyes, numberofmonths prefened: /Si esasi,numerodemeses de exoeriencia: I tyl.rr\ L^

16.

2. Check all requirements lhat applyi

tr Certificalion/License Requirements / Certificaci6n/Licencia RequisitosE Driver Requirements / Requisitos del conductorO Employer WillTrain / Empleador entrenara o adieskareO,Extensive Sitting / Eslar sentado largos ralos

ure lo Extreme Temp. / Expueslo a Temperaturas Exlremasrequiremenl / Levantar o Cargar al_lbs./libras

I\,4ovements / l\rovimientos repelitivos

O Criminal Background Check / Verificaci6n de antecedentes penates

iEa orug Screen / Deteccion de DrogasO Extensive Pushing and Pulling / Empujar y Jalar Exlensamenletr Exlenslve Walking / Caminar por largos ratostr_ F.equent Stoop ng / llcl landose o agacrandose co1 IrecLencra

'q oTi dol:ddy ts nol manoalory / Horas Extras ,sob.e tiempo) i Dias Eeriados 1o

obligatorio

v

17. Waqe Rates Speclal Pay lnformation ard Deductiofs / Tarlfa de Paqo, lniormaci6n Sobre Pagos Especlaies y Deducciones (Rebajas)

Crop Ac{ivities Hourly Wage Piece Rale IUnit(s)

Special Pay(bonus, etc.)

Deductions' Yes/Si No Pay Period /Periodo d€ Pago

Cultivos

'Flo.., t )Salario por Hora

\),X) Pago por Pieza /Unidadles)

Pagos Especrales(Bono elc.)

Deducciones

$ $ Social Secur ty /Sequro Social

F tr Weekly / Semanal

/,$ $ Federal Tax /lmpuestosFederales

( o

$ $ State Tax/lmp!eslosEslatales

a- tr Bi-weekly/Quincenal

o$ $ l\,4eals / Comidas tr A,

$ $ other (speciiy)/Otro (especifica)

D 9C [y'onlhly/Mersual

o

Other0tro

o

18. [,4ore Details Aboul the Pay / Mas Detalles Sobre el Pago:

N"n\- / ni .^1*^ .

19. Transportation Arrangements / Arreglos d€ Transportaci6n

E-ct^pron rc \*.r \\ pr.,: s. J' Q. \r urr-1g^. \*-\" ^ G--\r- Ns (A\-

\uc* \p"Nk-\^. Vo^ $,t- <r,,.Otc7Lr- Qre.:..It\ \xo.rs,"-.1\f.<- q.p;g-!z.- \\\{* .\ i.<-\u.,-i,J 6n-+ \\1 q^\ O-\ &"/

Aq+d

-4-

ls il the preva I ng pract ce to use Farrn Labor Conlractors (FLC) to recruit, sLrpervise lrarsport house and/or pay workers for this (lhesel crop aclv ly(ies)? / 4Es la praclica habltual usarContralslas deTrabaJo Agncola pa_ra reclutar, supervisar transportar darvvrenda y/o pagarle a los trabaiadoresoara F<le,osr 'lpo(stde co<ec1a(s,? Yes. Sr J NrX.--

lf you havecheckedyes what is the FLC wage for each actlvity? / Si conteslo"Si,'c!61 es el salario que le paga al ContratstadeTrabajoAgricola porcada activrdad?

21 Are workers covered for Unempioymenl lns!rance? / .Se le proporc onan Seguro de Desempleo a los trabajadores?

Are workers covered by workels' compensat on? / aSe le provee seguro de compensacion/indemn zacion al trabajador:

es/sANotr

v*rg(Noo

AIe tools, supplies, aid equipment provided at no charge to the wolkers? / aSe les proveen herramientas y equip0s s n costo algun o a l0s trabaiadores?

, es,516'-.ro -.t

24 List any arrangements which have been made with establishment owners or agents for the payment of a commission or other benefits for sales made towolkels. (lf there ale no such alrangemenls, entel 'None".) / Enumere todos los acuerdos o convenios hechos con los propietarios del establecimienio osus agentes para el pago de una comision u olros beneficios por ventas hechas a los irabajadores. (Si no hay ningin acuerdo o convenio, indique"Ninguno".)

A..r rx-- /r.1.,"..

25.Listanystrike,workstoppage,sloWdown,orinterrupiionofopera1ionbytheemployeesait6eenler "None'.)/ Enumere toda huelga, paro o intenupci6n de operaciones de irabajo por parte de los empleados en el lugar de empllo. (Si no lray iocidentes de estetipo, jndique'Ninguno'.)

/Urrut- f n i1".,0

-5-

22.

23.

20ls txtob order to be placed in connection wth a fulure Application for Temporary Employment Ceftfication for H-2A workerc? /.Esla orden de empleo ha sido puesta

en conexi6n con una fulura solicilud de cerlificaci6n de empleo temporal para irabajadores H-2A?

IYes/Sid\Io O

27. Employeis Certification:This job order describes theactualterms and conditions of the employmenl being offeled by me and contains all themaleriallerms and conditions of lhe iob. / Certificacidn del Empleador: Esta orden de trabaio describe los l6rminos y condiciones del empleo que se le olrece, y

conliene todos los lerminos y condiciones materiales ofrecidos.

t\or^o- Ve"lEmployer's Printed Name & Tilte / Nombre y Titulo en Letra de Molde/lmprenta del Empleador

v--t-Employer's Signature / Flrma y Titulo del Empleador

t4le,t" I )bDate / Fecha

READ CAREFULLY, ln view of the slatutorily esiablished basic function of lhe Employment Service as a no-fee labor exchange, lhat is, as a foIUm for bringingtogether employers and job seekers, neilher the Employment and Training Adminislration (ETA) nor the Stale agencies are guaranlors o, the accuracy orlruthfulness of information contained on job orders subrnilted by employers. Nor does any j0b order accepted or recruited upon by lhe American Job Cenlerconstitute a conlractualjob offer to lvhich the American Job Cenler, ETA or a Slate agency is in any way a party.

LEA CON CUIDADo, En visla de la funcion basica del Seryicio de Empleo establecida por ley, como una entidad de inlercambio laboralsin comrsiones, es decir, como un

loro para reunh a los empleadores y los solicitanles de empleo, ni ETA ni las agencias del estado pueden garanlizar la exaclilud o veracidad de la informacion contenida en

las ordenes de trabajo sometidas por los empleadores, Ni ninguna orden de kabajo aceptado o contratado en el Cenlro de Carreras (American Job Center) constiluyen una

ofeia de trabajo contmctuales a las que el Ame can Job Center, ETA o un organismo estatal es de ninguna manera una de las parles.

PUBLIC BURDEN STATEMENT

The public reporling burden for responding to ETA Form 790, which is req!ired to obtain or retain benelils (44 USC 3501) is e6timaled to be approximalely 60 minutes per

burden estimaie or any other aspeci of this collection, including suggestions for reducing this burden, tothe U.S. Deparlment ol LaboI, Employment and-frainingAdministration, office of Workforce lnveslment, Room C4510, 200 Constituuon Avenue, NW, Washlngton, DC 20210.

DEcLARActoN DE CARGA PoBLtcALa carga de informacion p0blica para responder a la Foma ETA 790, que se requiere para obtener o retener beneficios (44 USC 3501), se eslima en aploximadamente 60

minulos por respuesla, incluyendo eltiempo para revisar las inslrucciones, buscar fuentes de datos existentes, recopilar y revisar la coleccidn, Elpublico no liene por que

responder a esla recopilaci6n de informaci6n a menos que muestre un numero de conlrol oMB valido, Esta informaci6n es p0blica y no hay nlnguna expeclativa de

confidencialidad. Envie sus comentarios acerca de esta carga o cualquier otro aspecto de esta colecci6n, incluyendo sugerencias para reduciresta carga, al U.S.

Departrnenl of Labor, Employmenl and Training Adminislralion, office of Workforce lnveslment, Room C4510, 200 Constitution Avenue, NW, Washington, DC 20210.

-6-

28. Use ihis section to section Box number). lnclude attachments, if necessary. i Lltilice esta seccidn para proporcionarinformacidn adicionalde apoyoi incluya el numero de la secci6n e incluya archlvos adjufllos, Sres necesaTio.

/Vu,r- f N.tj*^-,

20 cFR 653.501Assurances

INTRASTATE AND INTER,STATE CLEAR,ANCE ORDER,

The employer agrees to provide to workers referred through the clearance system the number ofhours of work per week cited in Item 11 of the clearance order for the week beginning with theanticipated date of need, unless the employer has amended the date of need at least 10 workingdays prior to the original date of need by so notifying the Order-Holding Office (OHO). If theemployer fails to notify the oHO at least 10 working days prior to the original date of need, theemployer shall pay eligible workers referred through the intra state/interstate clearance systemthe specified hourly rate or pay, or in the absence of a specified hourly rate or pay, the higher ofthe Federal or State minimum wage rate for the first week stafting with the original anticipateddate of need. The employer may require workers to perform alternative work if the guarantee isinvoked and if such alternative work is stated on the job order.

The employer agrees that no extension of employment beyond the period of employment shownon the job order will relieve the employer from paying the wages already earned, or specified inthe job order as a term of employment, providing transportation or paying transportationexpenses to the worker's home.

The employer assures that all working conditions comply with applicable Federal and Stateminimum wage, child labor, social security, health and safety, farm labor contractor registrationand other em ployment-related laws.

The employer agrees to expeditiously notify the OHO or State agency by telephone immediatelyupon learning that a crop is maturing earlier or later, or that weather conditions, overrecruitment, or other factors have changed the terms and conditions of employment.

The employer, if acting as a farm labor contractor, has a valid farm labor contractor registrationcertificate.

The employer assures the availabillty of no cost or public housing which meets applicable Federaland State standards and which is sufficient to house the specified number of workers requestedth rough the clearance system.

The employer also assures that outreach workers shall have reasonable access to the workers inthe conduct of outreach activities pursuant to 20 CFR 653.107.

Employer's Name N,tfno"' We.t out", B/'trf )S

Employer's Signature

Besides the material terms and conditions of the employment, the employer must agree to these assurances ifthe job order is to be placed as part of the Agricultural Recruitment System. This assurance statement must besigned by the employer, and it must accompany the ETA Form 79O,

-8-

Page 1 of4Now Yark State Department of Labor

Fom ETA 790 AttachmentTerms and Corldltlons,lclarifications and Assurances/

Addltlonal lnformation

A: CLARIFICATION OF ITEMS ON FORM ETA 790

Item 3: Houslno

a. Housihg and ulilitieE are provided at no cosi to H.zA workers and those workers in conospondingemploymenl who are unable to return to their place of resldence the same day.

b. Hou6hg bed3, bedding, and mattr6sB6s will be furnished at no cost to the worke6.c, Housing wi,l be clean and meet the applicab,e Fedoral and State housing standards.d. Workerl will be respon$ible for maintaining housing and surounding areas in a neat, olean manner.

Erprov"i *irrl;rifr ,, provide three mea,s per day and witl deduct $ Nfl par day.

,E-TPI3-{- wW will iotfl fumish frae dlshes, cooking utensils and convenienl kilchen and cooking

Employer wilEl will notn provide tran€portation lo assure workers access to stores where thay canpurqhase groceries and/or other incidentals, andlor medical neces$ities.

Item 16: Job Sneclficatlons

a. Workers must be able to demonstratg that lhey are physiqally able to perform the work as described.b. ThfAenwglya(will prquhlF -' r fff$of ffi lning@f iflq(?c/|ow N l il l@?pt wptk twodFr to reach

prfja/qtiwlstspdaffiiftqpgtago1el" ,'L'u-.' V I /^\ .\-/1,,'l,' l' " i,1,tc. Pibdiletion,Stdnda'rdiif applicabldfAfter completion df traihihg or break-in period, empldyer will-' 11 expeol worker to:

Employer may terminate wofkor with timely notification to the NPC and DH$, jf the worken1) Refuses, without caus€, to perform work for which the worker was recrulted and hired;2) Comrnits serious acts of misoonduci;3)

4) Abandon6 Job (,Job Abandonmant") - is absent for tive consecutlve previously scheduled dayswithout prior notification to employer.

Item '17; Waqe Rates. SDeclal Pav lnformatlon and Dsductlons

The employer will oFfer, advertise in its recruitment, and pay a wage that is the highest of the AEWR, theprevailing hourly wage or pieoo rate, the agreed upon collective bargaining wage, or the Federal or $tateminimum wage, except where a special procedurc is approved for an occupation or specific cla6s ofagricultural employment, Employer assures that if a change in the AEWR requires an increase suchincrease Mll be paid a6 of the etfective dste of the increase. Also if the AEWR is decreased this will

, becoms ihe wage effective on the date ofthe decrease.a. lf pieoe rale earnings for total hours of work at a pisce rate during a pay period do noi result in

averagq houdy earnings equal to the guaranteed minimum hourly rate, lhe worker Mll receive make-up pay to the ggaranteed minimum wage Iate.

b, In New York Slate, the only deductions that can. be laken f.rom worl(er pay are:1. Thoso requirod by law, such as gocial Socuriry, income tax, and garnishment of wages; and2. Those that bonefit workers and are authorized in writing, slch as lite inBurance, or a savings

account.I

Page 2 of 4

Any other deductlons are lllegal,

c, The employer guaranlees to offer dmployment for a minimum of y] (''three-fourths guarantee") of thehours in the workdays during the period ot the contract, and all exlensions thereof. This guaranteobegins wlth the first workday afier the worker'g arrival at lhe place of employment and ends on thedate spocified on the Job order or €xtensions thereol ln fire, weather, or Act of God terminations (asdetermined by the Certlfying Officer) the % guarantee period ends on the date of termination. Theemployer must make efforts to trangfer the worker to other comparable employment acceptab,e io theworket, consistent with existing immlgration law, as applicable. lf suoh a transfer is nol aftected, theemployer must (1) return the worker, at the employefs expen6e, to the place from which the workor(disregarding intervening employment) came to work for the employer, or transport the worker to theworker's noxt certified H-2A employer, whichever the worker prefers; (2) reimburse the worker the fullamount of any deduotions made trom the worker's pay by the employer for transportation andsubsislence expenses to the place ot employmenti and (3) pay the worker tor any costs incuned bythe worker for transportatioI and daily subsistence to lhat employer's place of employment. Dailysubsislence musl b6 computed as set forth ln paragraph (h) of 655.1?2, The amount ot thekansportation payment musl not bg less (and is not required to b6 more) than the mosl economicaland reasonable common carier transportation charges for the distances invo,ved provide theguarantees in ltem '19 (a) below.

d. Workers will not be required to work more than the number of hours specified in the job order for aworkday or on their Sabbath or federal holidays to meet this guarantee. The worker's average hourlyearnings wlll be used under this guarantee where wages are paid on a piece rate basis. Workers whoare tefirrinated for cause or who voluntarily abandon their job are not entltled to this guarantee ifemployer provides timoly notification to the NPC and DHS.

e. On or before each payday the employor will provide to each worke. in one or more written statemenlsthe following information: (1) the workefs total earnings for the pay period; (2) the worker's hourly rateandlor piece rate ol pay: (3) the hours of employment offered to the worker (showing offers inaccordance with the % guarantee as determined in paragraph (i) of the regulations at 20 CFR sec.655.122(k),Eeparate from any hours offered over and above the guarantee); (4) the nours actuallyworked by the worker; (5) an itemization of all deductions made from the worker's wages; (6) if piecerates are used, the units produced daily; (7) beginning and ending dales of the pay periodi and (8) theerhployer's name, addross, and FEIN.

f. Worker8 with school age children who have migrated with such children and who depart in time toreturn home for the beginning ofthe school yea[ shall be paid, in addition to the basic wages, anyboflus or other incenlive payments or other expenses to which they would be entitled had they stayedthe entire job order period.

g. The employer will provide workers referred through the interstate clearance system !l o hours ofwork for the week beginning with the anticlpated date of need, !O!Eq employer has amended lhe dateof need by notavng the SWA no lat6r than 10 business days before the date of need. lf the employerfalls to notify the NYS Departmsnt of Labor, then the employer shall pay an ellgible worker referredthrough the clearance system Stt!,iu8(number of hours of work x AEwR/prevailing wage/minimumwage) for the first week starting with the originally anticipaled date of need. lf worker referred fails tonotif the NYS Department of Labor of continued interest in the iob al least 5 jlays before date ofneed, worker will be dlsquaflfied from this assurance. Employer willE will notfl require worker toperform aliernative work lf the guarantee citad in this section is invoked.Alt6rnative work:

h. Employer will maintain adequate paytoll recotds. Workers will be paid weekly on-5/) )- for work

through the previous ..i 0n- .

Page 3 of4

Itom 19: Transoortatlon

slz,aLEmployer aglees to reimburse inbound transpo*ation and subsistence exponsos (W per day minimumlo a maxirnum of $51,00 per day) to ea6h wofter, or any petson, governmont agency, or ptivateorganizaiion whi6h, on behalf of the worker, has paid or advanced such transportation and $ubslstenceexpenses, from the place ffom which the worker has come lo work for thg employer, whether in the U.S. orabroad to iho place of amployrnent, aftor the workGr has completed 50% of th6 6tiputated period ofemployment, from initial date of need or from the day after aotual arrival of worker if lBter than the stateddate to report.

a. Employer Wll provide or'pay the 006l oi return transportalion and subsistence to eaoh worker whocompletes theemploymena period, or who is terminated for medioal reasons, or a$ the result of tire,woather, or an Act of God (as determined by the Certifylng Ofiicer), from place of employment to ptaceof recruitm€nt, except if the worker prefers not to retufi to his place of recruitment and has subsequentomploymdnt with an employer - see ltem 17 (c) above. EmBloyer will not be responsible for providingreturn cosl ol transportation and 6ubsistence from place of employment io place ol recruitment if theworker voluntarily abandons the job or is terminated for cause and employer provides timely notrficationto the NPC and DHS.

b. The amount of lhe transportation paym€nt will be gqual to the mo6t economical and reasonable similarcommon carrier iran6portation charges for the di,stance involved. All transportation provided by theernployet will be by common carrier or other transportation tacllities which conform to the appiicableregulatlons of the lnterstate Commerce Comnission or ihe United States Depanmenl of Labor. Theamount of daily subsistence will be in accordance with current rateB published in the Federal Regrsrer(for \,lorkers with and without receipts).

c. It requested by the worker, employer will assist ln making transporialion arangem€ntr6.d. Emp,oyer Wlll provide trsnsportalion, at no cosl to th6 workcr, from the employer provided housing to

the actualwork sitd and roturn at lhe end ofthe day,

Item 22: Workers' ComDensation2r 1't,1 31.6 ^r 5\*l< 1.^).r.\,!- (..r,,..^1

The employer assures lhal Policy # issued by provides the required insurarice for rnjuriesarising out of and in the course of employment.Ernployefs pmof ol ihsurance coversge will be provided to the Qhicego Processing Cenler beforecertifioation ls granted.

Item 23: Tools and Eduioment

The employer will furnish without cost all tools, supplies, or equipment required in the performance ofwork.

OTHER CLARIFICATIONS AND ASSURANCES

The employer agr€os to abide. by th6 regulationB at 20 CFR 653.501 and 20 CFR 655.'135.The employer will expeditiously notify the $tate agency by telephone immedialely upon learning that a cropis maturing garlief or later, or that weather conditions, oyer-recruitment, or olher factors haye changed theterms and conditions of employment.

3. Outreaoh workers shall have reasonable access to the worker in the conduct of outreach activities pursuantto 20 CFR 653.501(xyi).

4. lf applicable, the employor is ce ilied in the use and application of pesiicides per Federal EnvironmentalProtection Agency and State Department of Environmental Conservatlon requirements. The employerassures that workers hired under this oder who will bd handling pesticides will be provided appropriatetrainirg, if applicable.

1.

Page 4 of 45, The employer will provide to an H-2A worker no later than the lime at whloh the worker applles for the visa,

or to a worker ln corresponding employment no later than on the day work commences, a copy oi the workcontract between the employer and the workers in a language unde6tood by the worker.

6, Tne employer as8ures that if acling as a farm labor oontractor (FLC) or farm labor contractor employee(FLCE) on thB order, he/she has a valid foderal FLC certificate or FLCE idenllfication oard.

7. The applicant assures that he/she oomplies with NYS registration requirements. Farm labor conkactorsanticipating employment contracting wilh growers or processors in New York State, growers or processorsin Nsw York State who use the services of a farm labor contractor, and growers or processors in New YorkSlaie who, without using the services of a larm laboa contractor, are responsible for bringing lnlo the statefive or more oul.of-state migrant tarm or food proc€ssing workers, not including H-2A worksrs, arerequired lo registff with the New York State Department of Labor. This statement applies on,y to H-2Asmployers who also employ five or more out-Of-state migrant worfers.

,\l \r/' tjEmployer stgnatu." f l l,** )f A

2t2016

Norman Keil NurseriesI 38A Fit",r.te Ro:rd, S,ril]t.J'.rnres Nl- II?81r

.. ' . Ph<.,ne: (6iil) 58.1-(1530 I'a:: (631) 862'8316

Ilcar Sir/1Vladam,

Thls will coD{lrm that I fully authorizc U.S. Americans Inc to prepare and submitany and all applications and petitions required by the USDOL, Department ofEomeland Security and the Departmert of State to approve the employment oftemporary foreip workers for our company.

This authorization is givetr to the following signatories of U.S. Americans Inc:John Gicmondi, V.P & Director of Operations, and John Gallo, President.

We, along with U.S. American Inc, do not utilize any agcnt or recruiter for therecruitment of II-2A workers under this application for temporary employmentcertification

We do not and will not receive payment of any kind from the workers for anyactivity related to obtaining H-2A labor c'ertificatlons or employment, includlngpayncnt ofthe employer's ag€nt or attorney fees, application and H-2A Petltionfees, recruitment cost, or any fees attributcd to obtaining the approved applicationfor Employment Certification.

This is to confirm that this occupation is rot party to any collective bargainingrgrccment goveming the job cla$ifrcrtion thrt is the subject of the E-2A laborcertlfi cation application.

Sincerely,

iti>"- t-,-_->-_Norman KeiIOwner . - ,t-tlt /t !

NY 11590-1463 . Tel: 516-997-1065/9187-fax

USDOLChicago NPCChicago, IL 60604

Dear Sir/lVlada m,

We at U.S. Americans Inc will not utilize any agent or recruiter for the recruitment of H-2A rvorkersuDder this application for Temporary Employment certification.

Director of Operations. tuleiy

ohn Gismondi

":y*,.US AMERICANS 888 Baldwin

B.

OMB Apptoval: 1 205-0466Expi ranon Date : 5n 1 /2ol 9

H-2A Application for Temporary Employment CertificationForm ETA.9142A - APPENDIX A

U.S. Department of Labor

For Use in Filing Applications Under the H-2A Agricultural Program ONLY

A. Attorney or Agent Declaration

I hercby cenify that I am an enployee of, or hircd by, the employer lisled in Section C of the Fom ETA-9142A, and that I havebeen designaled by that employer to act on its behalf in connection with this application, lf I am an agent and not anemployee of the employeL then I have attachecl a Lelter of Representation from the employer. I also cedify that lo the best ofmy knowledge the inlomatton conlained herein is true and cofiect. I understand thal to knowihgly fumish lalse infomation in theprcparction of this loftn and any supplement hereto ot lo aid, abel, or counsel another to do so is a felony punishable by a $250,000fine ot 5 years in a Federal penitentiary or both (18 U.S.C. 1001)

1. Attorney or Agent's last (family) name

GISMONDI2. First (given) name

JOHN3 Middle initial

4. Firm/Business name

U.S. AMERICANS INC5. E-Mail address

usamericans@aol.com7. Date signed

12t06t2018Employer Declaration

By vittue ol my signature below I HEREBY CER|IFY the fo owing conditions of employment:

1. The job opportunity is a full-time lemporary position, the qualificalions for which do not substantjally deviate from the normaland accepled qualifications required by non-H-2A employers in the same or comparable occupations and crops.

2. The specific job opportunity for which lhe employer s requesting H-2A cerlification is nol vacanl because the formeroccupant(s) is (are) on stdke or locked oul in lhe course of a labor dispute involving a work stoppage

3. The job opportunity is open to any qualifed U.S. worker regardless of race, color, nalional origin, age, sex, religion, handicap, orcitizenghip, and the employer has conducled and will conlinue to conduct the requ red recruilment, in accordance with regulations,and has been unsuccessful in locating sufficienl numbers of qualified t-1.S. applicants for the job opportunity for which certification issought. Any U.S. workers who applied or apply for the job were or will be rejected only for laMul, job'related reasons, and lheemployer must retain records of all rejections as required by 20 CFR 655-167.

4. The job opporiunity offers U.S. workers no less than the same benefits, wages, and working condilions thal lhe employer isoffering, intends to offer, or will provide to H-2A workers and complies with the requiremenls at 20 CFR 655, Subpart B.

5. The employer understands that it must offer. recruit al, and pay a wage that is at leasl the highest of the adverse effecl wagerate in elfect at the time the job order is placed. the prevailing hourly or piece rale, the agreed-upon collectave bargaining rate(CBA), or the Federal or State minimum wage, and, funhermore, thal if a new Adverse Effect Wage Rate is published, or theemployer is notified of a new prevailing wage rate during the contract period, and thal new rate is higher than the wagedetermined by lhe NPC (except the CBA) during the application process the employer will increase the pay of all employees rn

the same job occupation to the higher rate. For employers subject to the requirements at 20 CFR 655.200-235, the employerunderslands that it must offer, recruit at, and pay a wage that is at least the highest oI the adverse effect wage rate, theagreed-upon CBA, or the applicable minimum wage rate set by Federal or Stale law or judicial action, for each month, orportion thereof, during the iob order period.

6. There are no U.S. workers available in lhe area(s) capable of performing the iemporary services or labor in the jobopportunity, and the employer will conduct posilive recruitment as specified by the NPC and continue to cooperate with lheSWA by accepting relenais of all eligible U.S. workers who apply (or on whose behalf an application is made) for the jobopportunity until completion of 50% of the coniract period calculaled from the first dale of need indicaled in Section 8.5 ofForm ETA'g142A.

7. All fees associated Wth processing lhe temporary labor ce(ification will be paid in a timely manner.

Form ETA-91424 - Appendix A 1'O BL CONIPLEI trD Rl'EITIPLO] ER FROII ACERTIFIED FORII ETA-9ItzA I'ageA.lolA3

Casc Number: Case Status: Period of Employmenlr _to

aMB Awrovat 1 205-u66Expialon Dale : 581./201 9

H-2A Application for Temporary Employment Certification

Form ETA-9142A - APPENDIX AU.S. Department of Labor

11.

10.

During the period of employment that is the subject of the labor certification applioation, the employer:(i) Wll comply with applicable Federal, State and local employment-related laws and regulations, ancluding

employment-related health and safety laws;(ii) Will provide for or secure housing for workers who are not reasonably able to return to their permanent residence at

the end of the work day that complies with the applicable local, State, or Federal rtandards and guidelines forhousing without charge to the worker;

(iii) \Mlere required, has timely requested a preoccupancy inspection ofthe housing and received certificationl(iv) Wll provide insurance, without charge to lhe worker, under a Slate workers' compensation law or otherwise, thal

meels the requirements of 20 CFR 655.122(e).(v) Wjll provide transportalion in compliance with all applicable Federal, State or local laws and regulations between the

worker's living quarters (i.e., housing provided by the employer under 20 CFR 655.'122(d) and, ifapplicable, 655.230)and the employer's worksite \rlithout cost to the worker.

(vi) \Mll provide all tools, supplies, and equipment required to perform the duties, without charge to the worke..(vii) lMll provide meals and potable wate., without charge to the worker, if sLrbject to the requirements at 20 CFR

655.200-235.

The employer has not laid off and will not lay off any similarly employed U.S. worker in the occupation lhat is the subject of theH-2A Apolication for Tempo.aN Emplovment Certificalion in the area of intended employment except for laMul, job relatedreasons within 60 days of the date of need, or if the employer has lald ofi guch workers, it has ofiered lhe job opportunity that isthe subjeet of the application to those laid-off U.S. worke(s) and the tJ.S. worker(s) refused the job opportunity, was rejectedfor thejob opportunity for lawful, job-related reasons, orwas hired.

The employer and its agents have not sought or received paymeni of any kind from the H-2A worker for any aclivity retated toobtaining labor certification, including payment of the employer's altorneys'fees, application fees, or recruitment costs. Forpurposes of this paragraph, payment includes, but is nol limited to, monetary payments, wage concessions (includingdeductions from wages, salary, or benefits), kickbacks, bribes, tributes, in kind payments, and free tabor.

The employer has and will contractually forbid any foreign labor contractor or recruite. whom the employer engages ininternationat .ecruilment of H-2A workers lo seek or receive paymenls frcm prospective employees, except as provided for inDHS regulations.

The employer has nol and will not intimidate, threaten, reslrain, coerce, blacklist, or ln any manner discriminate against, andhas not and will not cause any person to intimidate, threaten, restrain, coerce, blacklist, or in any manner discriminale against,any person who has with just cause:

(i) Filed a complaint under or related to Sec. 218 of lhe INA (8 U.S.C. 1188), orany Department regulation promulgatedunder sec. 218 0fthe INA;

(ii) lnstituted or caused to be instiluted any proceeding under or related to Sec. 218 of the lNA, or any Departmentregulation promulgated under Sec. 218 ofthe INA;

(iii) Testified o. is about to testify in any proceeding unde. or related to Sec. 218 of the INA or any Oepartment regulationpromulgated under Sec. 218 ofthe INA;

(iv) Consulted with an employee ofa legal assistance program oran attorney on matlers related to Sec.218 olthe INAor any Department regulatjon promulgated under Sec. 218 ofthe INA; or

(v) Exercised or asserted on behalf of himself/herself or olhers any right or protection afforded by Sec. 218 ofthe lNA, orany Department regulation promulgated under Sec. 218 oflhe lNA.

The employer has not and wjll not discharge any person because ofthat person's taking any action ligted in paragraph 12(i) through(v) listed above.

The employer Wll inform H-2A wo*ers of the requirement that they leave the U.S. at the end of the period cerlified by theDepartment or separation from the employer, whichever is earlier, as requked under 20 CFR 655.135(i), unless the H-2Aworker is being sponsored by another subsequent employer.

The gmployer has posted the Notice of Workers' Rights as requked by 20 CFR 655.135(l) in a conspicuous place frequentedby allemployees,

'16. f the applicalion is being filed as an H-2A Labor Contractor the lollowing addilionalattestations and obligations apply under 20cFR 655.132:

(j) The H-2A Labor Contractor has provided a copy ofthe MSPA Farm Labor Contractor (FLC) certificate of registrationif required under MSPA, 1801 U.S.C. et seq., to have such a certitcate identirying the specific farm labor contractingactivities it is authorized to perform;

(il) The H-2A Labor Contractor has provided with this application a list of the names and locations of each lixed-siteagricultuIal business to which the H-2A Labor Contractor expecis to provide H-2A workers, the expected beginningand ending dates when the H-2A Labor Contractor will be providing the wo.kers to each fixed site, and a descriptioaofthe crops and aclivjties the workers are expected to perform al such fixed site;

(iiD The H'2A Labor Contractor is able to provide proof of its ability to discharge financial obligations under the H-2Aprogram and has secured a surety bond ar required by 29 CFR 501.9, the original of which is attached and shows

FOTM ETA.9I42A ' Appendix A TO BE COMPLf,TED BY EMPLOYtrR FROM A CERTIFTED FORM ETA.9142A Page A,2 ofA,3

13.

14.

15.

Case Numbc| Casc Statlls: I'eflod ofFmplo\ncn(:

12.

OMB Apwval 12otu466Expi ralion Date : 5n 1 /201 9

H-2A Application for Temporary Employment CertificationForm ETA-g142A -APPENDIX A

U.S. Department of Labor

the name, address, phone number, and contact person for the surely, and provides the amount of the bond (ascalculated pursuanl to 29 cFR 501.9);

(iv) The H-2A Labor Contractor has engaged in and will engage in recruitrnent effons in each area of intendedemployment in wiich it has lisled a fixed-site agricultural business as required in 20 CFR 655.121, 655.150-155 and655,215; and

(v) The H-2A Labor Contractor has obtained from each fixed'siie agricultural business that will provide housing ortrangportation to the workers a written statemeni stating ihat:

a.Ali housing used by workers and owrcd, operaled, or secured by the fixed-site agricultural businesscomplies with the applicable housing standards in 20 CFR 655.122(d) and, if applicable, 655.235; and

b. All transportation between the worksile and the workers' living quariers thai is provided by lhe fixed-siteagricultural business complies wilh all applicable Federal, State, or local laws and regulations and wlllprovide, at a minimum, lhe same vehicle safety slandards, driver licensure, and vehicle insurance asrequired unde.29 U.S.C. 1841 and 29 CFR part 500, except Where wo erc'compensation is used tocover such transponation as described in S 655.122(e); and

c. Attach to the statement cerlificates of occupancy from the SWA for all employer owned housing and copiesof ail drlvers' licenses, vehicle registration, and insurance policies ior all drivers and vehicles used tolransport H-2A workers.

I hereby acknowledge that lhe agent or attorney identified in section E (af any) of the Form ETA-9142A and section A above isaulhorized lo represent me for the purpose of labor cenification and, by virtue of my signature in Block 5 below, I take tullresponslbility for the accuracy of any represenlations made by my agenl or attorney.

I declarg under penally of perjury that I have read and reviewed ihis application and that to lhe best of my knowedge the informationcontaaned therein is true and accurale- I uderstand that to knowingly fumish talse in{ormation in the peparation of this tonn and anysupplenent tlErcto ot to aid, abet, or counsel another to do so is a felony punishable by a $25O,O00 tine or 5 Wars in tl?€ Federalpenitentiary or both (18 U.S.C. 1001).

'1. Last (family) name

Keil2. First (given) name

Norman3 Middle initia

4. Tifle

Owner5. Signature

{Y,6 Date signed

12t06t2018

Public Burden Statement

Persons are nol required to respond to thas collection of intormalion unless it displays a currently valid OMB control number. Public reportingburden for this collection of information is estimated lo average 'l hour to complete the form, including the time for reviewing insiruclions,searching existing data sources, gathering and maintainlng the dala needed, and compleling and reviewing the collection of informalion. Theobligation to respond to this data collection is required to obtain/retain benefits (lmmigration and Nationaliiy Act, 8 U.S.C. 1101, et seq.).Please send comments regarding this burden estimate or any other aspeci of this information colleclion to the Office of Foreign LaborCertificatjon ' U.S. Department of Labor ' Box 12-200 ' 200 Constatution Ave-, NW, " Washington, DC ' 202'10. Please dpjglsond thecompleted application to this address.

lorm ETA-9142A Appendix A TO DE COMPLEI IlD BY E]\{PLOYER FROIII A CERTIFIED FORN{ tr I A-9142A PageA3ofA.l

Case Number: Case Status: Period ofEmployment:

Nerv York State Insurancc Fundllitrkarr' Conpent-ution & Disobility Bene/its Sp<:tialists liitrtc l9l.l

155 CHURCH STREET. NEW YORK, N,Y, 101]07-1100

cERTIFICATE OF WORKERS' COMPENSATION lNSr.'RANCE {RENEWED)

^^^^^^ 112370766

IHE FLANDERS GROUP2B5O CLOVER STREETPIfiSFORD NY ,I4534

SCAN TO VALIDATEAND SUBSCRIBE

POLICYHOLDER

NORMAN KEIL NURSERIES INC,% NORMAN KEIL 38A FIFTY ACRE ROADSAINT JAI\,4ES NY 1 17BO

CERTIFICATE HOLDER

SUFFOLK CNTY DEPT OF HEALTH SEBUREAU OF PUBLIC HFALTH PROTEC360 YAPHANK AVENUE SUITE 2AYAPHANK NY 11980

POLICY NUNIBER21244 898-1

CERTIFICATE NUMBER273662

POLICY PERIODo4t01t2018 TO O4tO1t2A19

DATE2!2212018

.THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCEFUND UNDER POLICY NO, 1244 89A.1, COVERING THE ENTIRE OELIGATION OF THIS POLICYHOLOER FORWORKERS' COI\,IPENSATION UNDER THE NEW YORI( WORKERS' CO]\,1PENSATION LAW WII'I-I RESPECT IO ALLOPERATIONS IN THE STATE OF NEIV YORK, EXCEPT AS INDICATED BELOYV.

IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAIO POLICY, INCLUOING ANY NOTIFICATION OF CANCELLATIONS,OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPSJ/WWW.NYSIF.COMTCERTICERTVAL.ASP. THE NEWYORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS,

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORI\4ATION ONLYAND CONFERS NO RIGHTS NOR INSURANCECOVERAGE UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AI\4END. EXTEND OR ALTERTHE COVERAGE AFFORDED BY THE POLICY,

NEW YORK STATE INSURANCE FUND

,--{; / n.=;.-[..u.,-,^,,sJ.5G<-

VALIDATION NUMBER: 1 73599081u-26.3

DIRECTOR,INSURAI.]CE FUND I-]NDERWRIiING

KeilNurseriesl3A Fiin Acre R,nd, Srint |rnes \.-\: 11?StlPhooe: (631) 584-6ll{l Far: (r,i1) 862,8216

This is to confirm that we will have our Workmaa's Compensation policy throughout thework season.

Sincerelv./)izn^- 12,"{-Norman KeilOwner