HomeMy WebLinkAbout2012-164 IOU
INDIAN RIVER COUNTY
FOOD AND REFRESHMENT
DISCLOSURE FORM
SECTION 104 06 ( 5 ) ( b ) ( 2 ) OF THE COUNTY CODE
I consumed food and / or refreshments at a single sitting or event ,
the cost of which may have exceeded the per diem allowance under
Chapter 112 , F . S . , as follows :
Date of subject event : Z PEMZ b A
Meal ( circle one ) : breakfast , lunch , inner
Provided by : �VL! ! �1 sr J �
� t
Signature : _
Printed name : ����
Date :