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Form 5B-3: Complaint — Qui Tam Action IN THE UNITED STATES DISTRICT COURT FOR THE ___________ DISTRICT OF _____________ ____________ DIVISION United States, ) Via Relater, ) ) Case No. v. ) ) JURY DEMAND ABC Union, ) XYZ, Inc., ) Does 1 through 100, ) Defendants. ) Complaint and Jury Demand NOW COMES Relater, by his attorney, filing this action against the above referenced Defendants stating that: JURISDICTION AND VENUE 1. This is an action to recover damages and civil penalties on behalf of the United States of America arising out of false claims presented by Defendants under the Transportation Equity Act for the 21st Century and other federal capital funding programs. The action arises under the provisions of 31 U.S.C. §3729, et. seq. 2. 31 U.S.C. §3729(a) provides that “Any action under section 3730 may be brought in any judicial district in which any Defendant may be found to reside, or transact business, or in any district in which any proscribed act has occurred.” Some of the acts complained of herein occurred within this judicial district. 3. 31 U.S.C. §3730(b)(2) provides that the Complaint is to be filed in camera and remain under seal for a period of at least sixty (60) days and shall not be served on the [name] Defendants until the Court so orders. The Government may elect to intervene and proceed with the action within sixty (60) days after it receives both the Complaint and the material evidence and information. PARTIES TO THE ACTION 4. “Relater” a citizen and a resident of the State of _________, brings this action on behalf of the United States of America. 5. As required under the Act, Relater has furnished to the Attorney General of the United States and to the United States Attorney for the Northern District of __________, simultaneous with or prior to the filing of this Complaint, a statement of all material evidence and information related to the Complaint. This disclosure statement supports the existence of overcharges and false claims by the Union Defendants. 6. Since [date], Relater has worked as a service truck chauffeur for the Defendant X, hereinafter “Defendant X”, in Defendant X’s Utility Department. As a service truck chauffeur, Relater drives Defendant X’s staff and contract workers to their work sites along the Defendant X’s bus routes and rail systems and sets up the workers’ equipment. In this position, Relater provides support for all trades hired by the Defendant X. 7. As a service truck chauffeur in Defendant X’s Utility Department, Relater is occasionally assigned to assist other Defendant X staff or contract workers as a substitute driver. 8. Defendant X contracts Union workers including foremen, hereinafter collectively referred to as “ Defendants” to work approximately six or seven days a week to perform structural improvements and repairs to the elevated rail systems. 9. Occasionally, Relater drives Defendants to their work site and sets up their equipment. Relater performs this task approximately once every two months. Relater usually drives Defendants on weekends, but occasionally Relater drives Defendants for a full week or longer. 10. On information and belief, throughout its operation Defendant X has received federal capital funds to conduct the physical improvements to Defendant X’s facilities, which Mason Worker Defendants perform. 11. Mason Worker Defendants have submitted multiple false claims each year, resulting in hundreds of thousands of dollars in overpayment annually. Based upon the statutory civil penalty of five thousand dollars ($5,000) to ten thousand dollars ($10,000) for each false claim submitted and triple damages applied to the amount of overpayments, Relater estimates the total amount to be recovered from Mason Worker Defendants possibly exceeds nineteen million dollars ($19,000,000). 12. Defendant X acting with reckless disregard and/or deliberate ignorance of the falsity of the information has repeatedly approved the multiple false claims each year. 13. After approval, Defendant X acting with reckless disregard and/or deliberate ignorance of the falsity of the information allocated federal funds for payment of these false claims, resulting in loss of millions of dollars of federal taxpayer moneys. Based upon the statutory civil penalty of five thousand dollars ($5,000) to ten thousand dollars ($10,000) for each false claim submitted and triple damages applied to the amount of overpayments, Relater estimates the total amount to be recovered from Defendant X possibly exceeds nineteen million dollars ($19,000,000) as well. 14. The true names of the individual Mason Worker Defendants, Does 1 through 100, inclusive and each of them are unknown to Relater who, therefore, will sue these Mason Worker Defendants by such fictitious names and will ask leave of Court to amend this Complaint when the same shall have been ascertained. Relater is informed and believes, and upon such information and belief alleges that each Defendant designated herein as a Doe is responsible for the events and happenings referred to herein which caused the submission of false claims to the United States of America. 15. At all times herein mentioned, each of the Mason Worker Defendants was an agent, servant or employee of each of the remaining Mason Worker Defendants, and was at all times acting within the purpose or scope of said agency or employment, and was acting with the express or implied knowledge, permission or consent of the remaining Mason Worker Defendants, and each of them. FIRST CAUSE OF ACTION 16. Relater repeats and repleads and incorporates by reference each and every one of the allegations contained in paragraphs 1-15, inclusive, as though fully set forth herein. 17. On information and belief, throughout Defendant X’s operation federal capital funds have subsidized the physical improvements to Defendant X’s fleet and facilities. Further, the Transportation Equity Act for the 21st Century (“TEA-21”) provides record levels of capital investment dollars to continue rebuilding Defendant X’s rail system. 18. On information and belief the federal government subsidizes Defendant X’s projects based upon the financial needs and forecasts of completing that project. 19. Mason Worker Defendants and each of them sued in this cause of action submitted or caused to be submitted false and fraudulent claims and records, by means of the following: A. Local __________ Mason Workers, who were employed by Defendant X, and administrative members of Local __________ falsely and fraudulently billed for services which were not completed at the time billed for and which were never completed; B. Administrative members of Local __________, namely foremen, knowingly submitted or caused to be submitted to the Government the false and fraudulent time records from the Mason workers, for approval and/or payment. 20. Defendant BAT submitted or caused to be submitted false and fraudulent claims and records, by means of the following: A. Acted in deliberate ignorance and/or in reckless disregard of the falsity of the Mason Worker Defendants’ payroll information; B. Acted in deliberate ignorance and/or in reckless disregard of the falsity of the Local __________ Mason Workers’ job bids and costs forecasts. 21. Relater believes that the aforesaid acts have been undertaken by Mason Worker Defendants and Defendant X since [year], and possibly even earlier. 22. From [year] to the present, Mason Worker Defendants knowingly, or in reckless disregard of the truth, presented false claims to officers and/or employees and/or agents of the United States Government by submitting requests for payment for Mason Worker time which they knew was not worked. 23. From [year] to the present, Defendant X acting in deliberate ignorance of the truth or falsity of the information and/or acting in reckless disregard of the truth or falsity of the information presented false claims to officers and/or employees and/or agents of the United States Government by submitting requests for payments or funding for amounts which were excessive. 24. By virtue of their actions the Mason Worker Defendants and Defendant X defrauded the United States’ taxpayers of an amount in excess of $3,000,000. WHEREFORE, for the First Cause of Action, Relater asks that Judgment be rendered against the Mason Worker Defendants and Defendant X as follows: (1) for an amount equal to three times the damages sustained by the United States as a result of Mason Worker Defendants’ conduct; (2) a civil penalty of not less than five thousand dollars ($5,000) and not more than ten thousand dollars ($10,000) for each violation of 31 U.S.C. §3729; (3) that Relater, as Qui Tam Plaintiff, be awarded the maximum amount allowed pursuant to 31 U.S.C. §3730 and/or any other applicable provision of law; (4) that Relater be awarded attorney’s fees and costs according to proof; and (5) for such other and further relief as the Court deems just and proper.
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