DEPARTMENT OF INSURANCE

Course Attendance Information

PR01793: 5th Gear Enterprises, LLC
Experior Provider Number:	S15320
Provider Type:	Independent
Certification Date:	6/12/2018
Address:	22802 SW Forrest Creek Drive Suite 102 Sherwood, OR 97140
Contact:	Deborah Deragon
Telephone:	503-523-2339
Status:	Active
Termination Date:	N/A
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Course Attendees

Course Name : Essentials of the Personal Umbrella
DOI ID	Name	Completion Date	Compliance Date
923778	Jackson, Buddy	04/30/2023	06/30/2023
1123094	Darnell, Annie Rose	04/09/2023	04/30/2023
923778	Jackson, Buddy	05/04/2021	06/30/2021
854532	Crenshaw, Joseph Nathaniel	11/28/2019	03/31/2020