The created cartridge image has the OS, BASIC and Amsdos embedded in it and the data from the disk image (tracks/sectors).
Page 0 is OS. Page 1 is BASIC. Page 2 contains part of the disk image data. Page 3 contains AMSDOS. Page 4 onwards contains disk image data.
The image contains a patched Amsdos that reads from the cartridge rather than reading from disk.