Nir Yitzhak, D.N.

Negev 85455, ISRAEL Tel:972-8-9989720/1 Fax:972-8-9989710

www.polysack.com E-mail: sales@polysack.com

Free Trade Agreement between the United Mexican

States and the State of Israel
Certificate of Origin

1. Exporter name and address: 2. Blanket period

POLYSACK PLASTIC INDUSTRIES LTD. D D MM Y Y D D M M Y Y

NIR YITZHAK , D.N. NEGEVE 85455,
ISRAEL From: :_ From: to:

Telephone:972 8 9989700 Fax:972 8 9989710

Tax identification number: 513611863

4. Importer name and address:
3. Producer name and address: “SAME" POLYSACK MEXICO S.A. DE C.V.
AV. LAZARO CARDENAS No. 61,
ZONA INDUSTRIAL
Telephone: Fax: GUADALAJARA. JALISCO. MEXICO, C.P. 44940

Tax identification number: Telephone: 52 (33) 31454240 Fax: 52 (33) 31454270

Tax identification number PME 000823 D38

6. HS tariff 7. Preference 8. Producer 9. Method
5. Description of good(s) clasification Criterion used (RVC)
number

INVOICE NO.: 119595 y 119596.

Tejido de Urdimbre y trama crudo, de hilados 100% de 54.07.71.01 Yes
Monofilamentos sintéticos de polietilenos, con corte
Transversal inferior a 1mm.

Telas para sombreo y recubrimiento de plantíos agrícolas 60.05.32.99

e invernaderos (mallas tejidas). Yes
Tejido de malla de punto de urdimbre de polietileno teñidos.

10. Remarks: X PQ’s rules of origin ‫ٱ‬ Ruling (Specify):

11. I certify that:

- The information on this document is true and accurate and I assume the responsibility for proving such representations. I
understand that I am liable for any false statements or material omissions made on or in connection with this document.

- I agree to maintain and present upon request, documentation necessary to support this certificate, and to inform, in writing, all
persons to whom the certificate was given of any changes that could affect the accuracy or validity of this certificate.

- The goods originated in the territory of one or both Parties, and comply with the origin requirements specified for those goods in
the Free Trade Agreement between the United Mexican States and the State of Israel, and unless specifically exempted in Article
3-17, Annex to the Article 3-03 or Annex 3-03(3), there has been no further production or any operation outside the territories of
the Parties.

This certificate consists of ___1__ page, including all attachments.

Company:
Authorized signature: POLYSACK PLASTICK INDUSTRIES LTD

Name: ARIE GEMORE Title: H.Q. MANAGER – GLOBAL SALES

Date : D D M M Y Y Telephone:972 8 9989753 Fax:972 8 9989710

08.03.2010