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POLICY NUMBER INSURED NAME AND ADDRESS <br />B 4025961553 CARD METER SYSTEMS, INC. <br />5325 EAST ELENA AVENUE <br />MESA, AZ 85206 <br />..... ... q_. .... ... m .:: i ... .... _ . L n 1. _ . i ...... .. .. ... .. ...v i::.t. ..____ ... .. ... <br />FORMS AND ENDORSEMENTS SCHEDULE <br />COMMERCIAL PROPERTY <br />FORM NUMBER FORM TITLE <br />SE147084B 07/2009 Fungi, Wet Rot, Dry Rot and Microbe Exclusion <br />SE3001293 O1/2008 Targeted Hacker Attack <br />SB3001393 O1/2008 Protective Safeguards <br />SB300146C O1/2008 Cap on Losses from Certified Acts of Terrorism <br />SB300179D 07/2009 Choice Endorsement <br />SB300456A 07/2007 Concurrent Causation, Earth Mcvmnt, Water Excl Chg <br />SE300596A O1/2008 Identity Theft/Recovery Services Endorsement <br />COMMERCIAL GENERAL LIABILITY <br />FORM NUMBER <br />FORM TITLE <br />SB146932D <br />07/2009 <br />Blanket Additional Insured - Liability Extension <br />SB147079A <br />01/2006 <br />War Liability Exclusion <br />SB147080A <br />O1/2006 <br />Exclusion - Silica <br />SB147081A <br />O1/2006 <br />Exclusion - Respirable Dust <br />SB147083B <br />07/2009 <br />Fungi/Mold/Mildew/Yeast/Microbe Exclusion <br />SE147089A <br />O1/2006 <br />Employment - Related Practices Exclusion <br />SB300000C <br />04/2010 <br />Businessowners Liability Coverage Form <br />SB300113B <br />01/2007 <br />Additional Insured - Designated Person <br />SB300441A <br />O1/2007 <br />Fiduciary Liability Coverage Form <br />SB300449A <br />O1/2007 <br />Single Limit of Insurance Endorsement <br />SE300450A <br />O1/2007 <br />Employment Practices Liability Coverage Form <br />SB300849A <br />07/2009 <br />Reed and Distribution of Material or information <br />*** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** <br />FORM NUMBER FORM TITLE <br />SB146959G 02/2010 Policyholders Jurisdictional Inspection <br />SB200144C 01/2008 Offer of Terrorism Coverage Notice <br />SB300999A 04/2010 Businessowners CL Cov Form Policyholder Notice <br />Countersignature <br />VOTO <br />Chairman of the Boars -- A E. STORG <br />�Gi,,.,igant City <br />Attorney <br />SE-146895-A (Ed. 01/06) AGENT Page 8 of <br />