HomeMy WebLinkAbout2011-002INDIAN 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:
breakfast, lunch, dinner
Meal (circle one)
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Provided by: i M
C
Signature:
Printed name:
name:
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