HomeMy WebLinkAbout2011-236 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 :
Meal ( circle one ) : breakfast , lunch , ' dinner
Provided by : /D /Tk
Signature :
Printe gxame : SOS E loll �
Date :