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POLICY NUMBER INSURED NAME AND ADDRESS <br />B 4a25961553 CARD METER SYSTEMS, INC. <br />5325 EAST ELENA AVENUE <br />MESA, AZ 85206 <br />FORMS AND <br />COMMERCIAL PROPERTY <br />SCHEDULE <br />FORM NUMBER FORM TITLE <br />SB147084B 07/2009 Fungi, Wet Rot, Dry Rot and Microbe Exclusion <br />SE300129B O1/2008 Targeted Hacker Attack <br />S3300139B 01/2008 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 Movmnt, Water Excl Chg <br />SB300596A O1/2008 Identity Theft/Recovery Services Endorsement <br />COMMERCIAL GENERAL LIABILITY <br />FORM NUMBER <br />FORM TITLE <br />SBI46932D <br />07/2009 <br />Blanket Additional Insured - Liability Extension <br />SB147079A <br />O1/2006 <br />War Liability Exclusion <br />SB147080A <br />01/2006 <br />Exclusion- Silica <br />SE147081A <br />O1/2006 <br />Exclusion - Respirable Dust <br />SB147083B <br />07/2009 <br />Fungi/Mold/Mildew/Yeast/Microbe Exclusion <br />SB147089A <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 />SB300450A <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 />SB300144C 01/2008 Offer of Terrorism Coverage Notice <br />SB300999A 04/2010 Businessowners CL Cov Form Policyholder Notice <br />Chairman of the Board <br />SB-146895-A (Ed. 01/06) <br />VOTO <br />u ISA E STQRCK <br />is ;1;011)nt City Attorney <br />AGENT y/ <br />Countersignature <br />retar <br />Page 8 of <br />