Laserfiche WebLink
,. ._ - 7 / 27 / 94 fcloc / disc loa2cloc ) ow � ,�g ip +CJ 49' V <br /> 022 <br /> INDIAN RIVER COUNTY <br /> FOOD AND REFRESHMENT <br /> DISCLOSURE FORM <br /> SECTION 104 . 06 ( 5 ) ( b ) ( 2 ) OF THE COUNTY CODE <br /> I consumed food and / or refreshments at a single sitting or event , <br /> the cost of which may have exceeded the per diem allowance under <br /> Chapter 112 , F . S . , as follows : <br /> Date of subject event : <br /> Meal ( circle one ) : <br /> breakfast , lunch , dinner <br /> Provided by . �S a _ <br /> Signature : e'-"' <br /> Printed name * <br /> e��� �d-� C <br /> Date : /LG Lj L� , Zb / / <br />