UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549  

FORM 10-Q  

(Mark One)
ý
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2018
or
¨
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from            to            .
Commission File Number: 001-36730
 

SYNEOS HEALTH, INC.
(Exact name of registrant as specified in its charter)
Delaware
 
27-3403111
(State or other jurisdiction of incorporation or organization)
 
(I.R.S. Employer Identification No.)
3201 Beechleaf Court, Suite 600, Raleigh, North Carolina 27604-1547
(Address of principal executive offices and Zip Code)
(919) 876-9300
(Registrant’s telephone number, including area code)

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes    ý       No     ¨
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate website, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes     ý       No    ¨
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one): 
Large accelerated filer
 
x
  
Accelerated filer
 
¨
Non-accelerated filer
 
¨ (Do not check if a smaller reporting company)
  
Smaller reporting company
 
¨
 
 
 
 
Emerging growth company
 
¨
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes    ¨      No     ý
As of October 29, 2018 , there were approximately 103,225,918 shares of the registrant’s common stock outstanding.



Table of Contents






SYNEOS HEALTH, INC.
FORM 10-Q


TABLE OF CONTENTS
 
 
 
 
 
 
 
Page
Item 1.
 
 
 
 
 
Item 2.
Item 3.
Item 4.
 
 
 
 
 
 
 
 
Item 1.
Item 1A.
Item 2.
Item 5.
Item 6.
 
 


2



Table of Contents



PART I. FINANCIAL INFORMATION
Item 1. Financial Statements.
SYNEOS HEALTH, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited)

 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
 
(In thousands, except per share data)
Service revenue
$
1,114,918

 
$
592,207

 
$
3,244,644

 
$
1,102,372

Reimbursable out-of-pocket expenses

 
230,121

 

 
493,009

Total revenue
1,114,918

 
822,328

 
3,244,644

 
1,595,381

 
 
 
 
 
 
 
 
Costs and operating expenses:
 
 
 
 
 
 
 
Direct costs (exclusive of depreciation and amortization)
539,570

 
405,798

 
1,619,620

 
722,643

Reimbursable out-of-pocket expenses
332,644

 
230,121

 
940,882

 
493,009

Selling, general, and administrative
96,943

 
88,855

 
296,420

 
176,320

Restructuring and other costs
19,349

 
6,670

 
41,647

 
12,626

Transaction and integration-related expenses
18,561

 
84,340

 
61,804

 
108,081

Asset impairment charges

 
30,000

 

 
30,000

Depreciation
17,639

 
14,049

 
53,224

 
26,279

Amortization
50,395

 
51,383

 
150,333

 
70,309

Total operating expenses
1,075,101

 
911,216

 
3,163,930

 
1,639,267

Income (loss) from operations
39,817

 
(88,888
)
 
80,714

 
(43,886
)
 
 
 
 
 
 
 
 
Other expense, net:
 
 
 
 
 
 
 
Interest income
1,004

 
501

 
3,498

 
765

Interest expense
(33,097
)
 
(27,432
)
 
(97,727
)
 
(33,818
)
Loss on extinguishment of debt
(1,789
)
 
(102
)
 
(3,914
)
 
(102
)
Other (expense) income, net
(4,346
)
 
(5,953
)
 
15,101

 
(16,164
)
Total other expense, net
(38,228
)
 
(32,986
)
 
(83,042
)
 
(49,319
)
Income (loss) before provision for income taxes
1,589

 
(121,874
)
 
(2,328
)
 
(93,205
)
Income tax expense
(11,983
)
 
(26,124
)
 
(19,058
)
 
(30,217
)
Net loss
$
(10,394
)
 
$
(147,998
)
 
$
(21,386
)
 
$
(123,422
)
 
 
 
 
 
 
 
 
Loss per share:
 
 
 
 
 
 
 
Basic
$
(0.10
)
 
$
(1.70
)
 
$
(0.21
)
 
$
(1.90
)
Diluted
$
(0.10
)
 
$
(1.70
)
 
$
(0.21
)
 
$
(1.90
)
Weighted average common shares outstanding:
 
 
 
 
 
 
 
Basic
103,012

 
87,152

 
103,453

 
65,097

Diluted
103,012

 
87,152

 
103,453

 
65,097


The accompanying notes are an integral part of these condensed consolidated financial statements.

3



Table of Contents



SYNEOS HEALTH, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS
(Unaudited)

 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
 
(In thousands)
Net loss
$
(10,394
)
 
$
(147,998
)
 
$
(21,386
)
 
$
(123,422
)
Unrealized gain (loss) on derivative instruments, net of income tax (expense) benefit of ($475), $72, ($475), and $163, respectively
2,624

 
(115
)
 
1,341

 
(248
)
Foreign currency translation adjustments, net of income tax benefit (expense) of $2,868, ($5,873), $0 and ($5,873), respectively
(1,295
)
 
4,626

 
(36,541
)
 
16,958

Comprehensive loss
$
(9,065
)
 
$
(143,487
)
 
$
(56,586
)
 
$
(106,712
)

The accompanying notes are an integral part of these condensed consolidated financial statements.



4



Table of Contents



SYNEOS HEALTH, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited)
 
September 30, 2018
 
December 31, 2017
 
(In thousands, except share data)
ASSETS
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
132,402

 
$
321,262

Restricted cash
2,202

 
714

Accounts receivable billed, net
656,682

 
642,985

Accounts receivable unbilled
347,894

 
373,003

Contract assets
136,824

 

Prepaid expenses and other current assets
80,418

 
84,215

Total current assets
1,356,422

 
1,422,179

Property and equipment, net
175,128

 
180,412

Goodwill
4,352,825

 
4,292,571

Intangible assets, net
1,189,665

 
1,286,050

Deferred income tax assets
32,702

 
20,159

Other long-term assets
102,951

 
84,496

Total assets
$
7,209,693

 
$
7,285,867

 
 
 
 
LIABILITIES AND SHAREHOLDERS' EQUITY
 
 
 
Current liabilities:
 
 
 
Accounts payable
$
82,204

 
$
58,575

Accrued liabilities
527,225

 
500,303

Contract liabilities
709,027

 
559,270

Current portion of capital lease obligations
16,603

 
16,414

Current portion of long-term debt
62,050

 
25,000

Total current liabilities
1,397,109

 
1,159,562

Capital lease obligations, non-current
21,568

 
20,376

Long-term debt, non-current
2,775,631

 
2,945,934

Deferred income tax liabilities
58,612

 
37,807

Other long-term liabilities
123,745

 
99,609

Total liabilities
4,376,665

 
4,263,288

 
 
 
 
Commitments and contingencies (Note 17)

 

 
 
 
 
Shareholders' equity:
 
 
 
Preferred stock, $0.01 par value; 30,000,000 shares authorized, 0 shares issued and outstanding at September 30, 2018 and December 31, 2017, respectively

 

Common stock, $0.01 par value; 600,000,000 shares authorized, 103,223,093 and 104,435,501 shares issued and outstanding at September 30, 2018 and December 31, 2017, respectively
1,032

 
1,044

Additional paid-in capital
3,390,734

 
3,414,389

Accumulated other comprehensive loss, net of tax
(53,735
)
 
(22,385
)
Accumulated deficit
(505,003
)
 
(370,469
)
Total shareholders' equity
2,833,028

 
3,022,579

Total liabilities and shareholders' equity
$
7,209,693

 
$
7,285,867


The accompanying notes are an integral part of these condensed consolidated financial statements.

5



Table of Contents



SYNEOS HEALTH, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited )
 
Nine Months Ended September 30,
 
2018
 
2017
 
(In thousands)
Cash flows from operating activities:
 
 
 
Net loss
$
(21,386
)
 
$
(123,422
)
Adjustments to reconcile net loss to net cash provided by operating activities:
 
 
 
Depreciation and amortization
203,557

 
96,588

Amortization of capitalized loan fees and original issue discount, net of Senior Notes premium
85

 
759

Share-based compensation
26,045

 
50,928

(Recovery of) provision for doubtful accounts
(3,453
)
 
1,477

(Benefit from) provision for deferred income taxes
(721
)
 
12,733

Foreign currency transaction adjustments
(14,927
)
 
6,264

Asset impairment charges

 
30,000

Fair value adjustment of contingent tax-sharing obligation
3,582

 

Loss on extinguishment of debt
3,914

 
102

Other non-cash items
3,084

 
1,404

Changes in operating assets and liabilities, net of effect of business combinations:
 
 
 
Accounts receivable, unbilled services, and advanced billings
(48,802
)
 
39,618

Accounts payable and accrued expenses
5,371

 
(10,132
)
Other assets and liabilities
34,651

 
3,427

Net cash provided by operating activities
191,000

 
109,746

Cash flows from investing activities:
 
 
 
Payments associated with business acquisitions, net of cash acquired
(90,890
)
 
(1,678,381
)
Purchases of property and equipment
(42,963
)
 
(28,153
)
Other, net

 
107

Net cash used in investing activities
(133,853
)
 
(1,706,427
)
Cash flows from financing activities:
 
 
 
Proceeds from issuance of long-term debt, net of discount

 
2,598,000

Payments of debt financing costs
(3,062
)
 
(25,476
)
Repayments of long-term debt
(354,396
)
 
(475,097
)
Proceeds from accounts receivable financing agreement
183,600

 

Proceeds from revolving line of credit

 
15,000

Repayments of revolving line of credit

 
(40,000
)
Redemption of Senior Notes and associated breakage fees

 
(290,250
)
Payments of capital leases
(12,664
)
 
(3,586
)
Payments for repurchase of common stock
(74,985
)
 

Proceeds from exercise of stock options
18,042

 
17,048

Payments related to tax withholding for share-based compensation
(3,212
)
 
(5,391
)
Net cash (used in) provided by financing activities
(246,677
)
 
1,790,248

Effect of exchange rate changes on cash, cash equivalents, and restricted cash
2,158

 
8,883

Net change in cash, cash equivalents, and restricted cash
(187,372
)
 
202,450

Cash, cash equivalents, and restricted cash - beginning of period
321,976

 
103,078

Cash, cash equivalents, and restricted cash - end of period
$
134,604

 
$
305,528

 
 
 
 
Supplemental disclosures of non-cash investing activities:
 
 
 
Fair value of shares issued and share-based awards assumed in business combinations
$

 
$
2,769,471

Fair value of contingent consideration related to business combinations
$
4,353

 
$

Purchases of property and equipment included in liabilities
$
7,589

 
$
706

Vehicles acquired through capital lease agreements
$
24,000

 
$
7,101

The accompanying notes are an integral part of these condensed consolidated financial statements.

6



Table of Contents



SYNEOS HEALTH, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

1 . Basis of Presentation and Changes in Significant Accounting Policies
Nature of Operations
Syneos Health, Inc. (the “Company”) is a global provider of end-to-end biopharmaceutical outsourcing solutions. The Company operates under two reportable segments, Clinical Solutions and Commercial Solutions, and derives its revenue through a suite of services designed to enhance its customers’ ability to successfully develop, launch, and market their products. The Company offers its solutions on both a standalone and integrated basis with biopharmaceutical development and commercialization services ranging from Phase I-IV clinical trial services to services associated with the commercialization of biopharmaceutical products. The Company’s customers include small, mid-sized, and large companies in the pharmaceutical, biotechnology, and medical device industries.
Merger
On August 1, 2017, the Company completed the merger (the “Merger”) with Double Eagle Parent, Inc. (“inVentiv”), the parent company of inVentiv Health, Inc. Upon closing, inVentiv was merged with and into the Company, with the Company continuing as the surviving corporation. Beginning August 1, 2017, inVentiv’s results of operations are included in the accompanying unaudited condensed consolidated financial statements. For additional information related to the Merger, refer to “Note 3 - Business Combinations .”
Unaudited Interim Financial Information
The Company prepared the accompanying unaudited condensed consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. The significant accounting policies followed by the Company for interim financial reporting are consistent with the accounting policies followed for annual financial reporting.
The unaudited condensed consolidated financial statements, in management’s opinion, include all adjustments of a normal recurring nature necessary for a fair presentation. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 , filed with the Securities and Exchange Commission on February 28, 2018 . The results of operations for the three and nine months ended September 30, 2018 are not necessarily indicative of the results to be expected for the full year ending December 31, 2018 or any other future period. The unaudited condensed consolidated balance sheet at December 31, 2017 is derived from the amounts in the audited consolidated balance sheet included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 .
Recently Adopted Accounting Standards
Revenue from Contracts with Customers. The Company adopted Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers (“ASC 606”) on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the three and nine months ended September 30, 2018 reflect the application of ASC 606, while the reported results for the three and nine months ended September 30, 2017 were prepared under ASC 605, Revenue Recognition (“ASC 605”). For additional information related to the impact of adopting this standard, refer to “Note 12 - Revenue from Contracts with Customers .”

7






Statement of Cash Flows - Restricted Cash. Effective January 1, 2018, the Company adopted ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash using the retrospective transition method, as required by the new standard. The adoption of this ASU had an insignificant impact to the Company’s unaudited condensed consolidated statements of cash flows. The following table provides a reconciliation of cash and cash equivalents and restricted cash reported within the unaudited condensed consolidated balance sheets at September 30, 2018 and December 31, 2017 , which sum to the total of such amounts in the consolidated statements of cash flows (in thousands):
 
September 30, 2018
 
December 31, 2017
Cash and cash equivalents
$
132,402

 
$
321,262

Restricted cash
2,202

 
714

Total cash and cash equivalents and restricted cash shown in the condensed consolidated statements of cash flows
$
134,604

 
$
321,976

Comprehensive Income - Reclassifications of Certain Tax Effects. Effective January 1, 2018, the Company elected to early adopt ASU No. 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income . Under the updated accounting guidance, the Company is allowed to reclassify the stranded tax effects within accumulated other comprehensive income to retained earnings in each period in which the effect of the change in the U.S. federal corporate income tax rate resulting from the Tax Cuts and Jobs Act of 2017 (“Tax Act”) is recorded. Upon adoption, the Company recorded an increase to other comprehensive income of $3.9 million and a reduction in retained earnings of $3.9 million . There was no impact on prior periods.
Recently Issued Accounting Standards Not Yet Adopted
Leases. In February 2016, the Financial Accounting Standards board (“FASB”) issued ASU No. 2016-02, Leases . ASU 2016-02 requires organizations to recognize lease assets and lease liabilities on the balance sheet, including leases that were previously classified as operating leases. The ASU also requires additional disclosures about leasing arrangements related to the amount, timing, and uncertainty of cash flows arising from leases. The amendments in this ASU are effective for financial statements issued for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption of the amendments is permitted and the new guidance will be applied using a modified retrospective approach. The Company continues to evaluate the impact of adopting this standard on its accounting policies, financial statements, business processes, systems and internal controls. Additionally, the Company has established a project management and implementation team consisting of internal resources and external advisors. These evaluation and implementation processes are expected to continue through 2018. The Company expects to recognize substantially all of its leases on the balance sheet by recording a right-to-use asset and a corresponding lease liability. The Company plans to adopt the standard on January 1, 2019.
2 . Financial Statement Details
Cash and Cash Equivalents
Certain of the Company’s subsidiaries participate in a notional cash pooling arrangement to manage global liquidity requirements. The participants combine their cash balances in pooling accounts at the same financial institution with the ability to offset bank overdrafts of one participant against positive cash account balances held by another participant. The net cash balance related to this pooling arrangement is included in the “Cash and cash equivalents” line item in the unaudited condensed consolidated balance sheet. The Company’s net cash pool position consisted of the following (in thousands):
 
September 30, 2018
 
December 31, 2017
Gross cash position
$
130,510

 
$
195,376

Less: cash borrowings
(105,708
)
 
(88,226
)
Net cash position
$
24,802

 
$
107,150


8






Billed Accounts Receivable, Net
Billed accounts receivable, net consisted of the following (in thousands):
 
September 30, 2018
 
December 31, 2017
Accounts receivable billed
$
662,138

 
$
652,061

Allowance for doubtful accounts
(5,456
)
 
(9,076
)
Accounts receivable billed, net
$
656,682

 
$
642,985

Accounts Receivable Factoring Arrangement
In May 2017, the Company entered into an accounts receivable factoring agreement to sell certain eligible unsecured trade accounts receivable, without recourse, to an unrelated third-party financial institution for cash. For the nine months ended September 30, 2018 , the Company factored $197.4 million of trade accounts receivable on a non-recourse basis and received $196.4 million in cash proceeds from the sale. The fees associated with this transaction were insignificant. The Company did not sell any trade accounts receivables under this agreement during the year ended December 31, 2017 .
Goodwill and Intangible Assets
Changes in the carrying amount of goodwill by segment for the nine months ended September 30, 2018 were as follows (in thousands):
 
Total
 
Clinical
Solutions
 
Commercial
Solutions
Balance at December 31, 2017:
 
 
 
 
 
Gross carrying amount
$
4,308,737

 
$
2,808,975

 
$
1,499,762

Accumulated impairment losses (a)
(16,166
)
 
(8,142
)
 
(8,024
)
Goodwill net of accumulated impairment losses
4,292,571

 
2,800,833

 
1,491,738

2018 Activity:
 
 
 
 
 
Business combinations  (b)
73,901

 
(5,692
)
 
79,593

Impact of foreign currency translation
(13,647
)
 
(12,950
)
 
(697
)
Balance at September 30, 2018:
 
 
 
 
 
Gross carrying amount
4,368,991

 
2,790,333

 
1,578,658

Accumulated impairment losses (a)
(16,166
)
 
(8,142
)
 
(8,024
)
Goodwill net of accumulated impairment losses
$
4,352,825

 
$
2,782,191

 
$
1,570,634

(a) Accumulated impairment losses associated with the Clinical Solutions segment were recorded prior to 2018 and related to the former Phase I Services segment, now a component of the Clinical Solutions segment. Accumulated impairment losses associated with the Commercial Solutions segment were recorded prior to 2018 and related to the former Global Consulting segment, now a component of the Commercial Solutions segment. No impairment of goodwill was recorded for the nine months ended September 30, 2018 .
(b) Amount represents measurement period adjustments to goodwill recognized in connection with the Merger and goodwill recognized in connection with an acquisition. Goodwill associated with these transactions is not deductible for income tax purposes. Refer to “Note 3 - Business Combinations” for further information.


9






Intangible assets, net consisted of the following (in thousands):
 
September 30, 2018
 
December 31, 2017
 
Gross
 
Accumulated Amortization
 
Net
 
Gross
 
Accumulated Amortization
 
Net
Intangible assets with finite lives:
 
 
 
 
 
 
 
 
 
 
 
Customer relationships
$
1,489,824

 
$
(368,905
)
 
$
1,120,919

 
$
1,440,178

 
$
(266,158
)
 
$
1,174,020

Acquired backlog
136,847

 
(86,329
)
 
50,518

 
137,442

 
(42,095
)
 
95,347

Trademarks
31,290

 
(13,062
)
 
18,228

 
32,428

 
(15,745
)
 
16,683

Total
$
1,657,961

 
$
(468,296
)
 
$
1,189,665

 
$
1,610,048

 
$
(323,998
)
 
$
1,286,050

The fair value of the intangible assets acquired during the three months ended September 30, 2018 are amortized over an estimated useful life of 5 to 10 years . The future estimated amortization expense for the Company’s intangible assets is expected to be as follows (in thousands):
Fiscal Year Ending:
 
2018 (remaining 3 months)
$
51,280

2019
166,353

2020
149,620

2021
132,261

2022
126,856

2023 and thereafter
563,295

Total
$
1,189,665

Accumulated Other Comprehensive Loss, Net of Tax
Accumulated other comprehensive loss, net of tax, consisted of the following (in thousands):
 
September 30, 2018
 
December 31, 2017
Foreign currency translation adjustments, net of tax
$
(56,461
)
 
$
(23,514
)
Unrealized gains on derivative instruments, net of tax
2,726

 
1,129

Accumulated other comprehensive loss, net of tax
$
(53,735
)
 
$
(22,385
)
Changes in accumulated other comprehensive gain (loss), net of tax for the three months ended September 30, 2018 were as follows (in thousands):
 
Unrealized gain on derivative instruments, net of tax
 
Foreign currency translation adjustments, net of tax
 
Total
Balance at June 30, 2018
$
102

 
$
(55,166
)
 
$
(55,064
)
Other comprehensive gain (loss) before reclassifications
2,397

 
(1,295
)
 
1,102

Amount of loss reclassified from accumulated other comprehensive loss into statement of operations
227

 

 
227

Net current period other comprehensive gain (loss), net of tax
2,624

 
(1,295
)
 
1,329

Balance at September 30, 2018
$
2,726

 
$
(56,461
)
 
$
(53,735
)

10






Changes in accumulated other comprehensive gain (loss), net of tax for the nine months ended September 30, 2018 were as follows (in thousands):
 
Unrealized gain on derivative instruments, net of tax
 
Foreign currency translation adjustments, net of tax
 
Total
Balance at December 31, 2017
$
1,129

 
$
(23,514
)
 
$
(22,385
)
Reclassification of income tax benefit due to adoption of ASU 2018-02
256

 
3,594

 
3,850

Balance at January 1, 2018
1,385

 
(19,920
)
 
(18,535
)
Other comprehensive gain (loss) before reclassifications
1,712

 
(36,541
)
 
(34,829
)
Amount of gain reclassified from accumulated other comprehensive loss into the statement of operations
(371
)
 

 
(371
)
Net current period other comprehensive gain (loss), net of tax
1,341

 
(36,541
)
 
(35,200
)
Balance at September 30, 2018
$
2,726

 
$
(56,461
)
 
$
(53,735
)
Unrealized gains on derivative instruments represent the effective portion of gains associated with interest rate swaps. Designated as cash flow hedges, the interest rate swaps limit the variable interest rate exposure associated with the Company’s term loans. The Company reclassifies amounts into net income (loss) as it makes interest payments on its term loan. Amounts to be reclassified to net income (loss) in the next 12 months are expected to be inconsequential.
The tax effects allocated to each component of other comprehensive loss for the three months ended September 30, 2018 were as follows (in thousands):
 
Before-Tax Amount
 
Tax (Expense) or Benefit
 
Net-of-Tax Amount
Foreign currency translation adjustments
$
(4,163
)
 
$
2,868

 
$
(1,295
)
Unrealized gain on derivative instruments:
 
 
 
 
 
Unrealized gain arising during period
2,863

 
(466
)
 
2,397

Reclassification adjustment for losses realized in net loss
236

 
(9
)
 
227

Net unrealized gain on derivative instruments
3,099

 
(475
)
 
2,624

Other comprehensive (loss) income
$
(1,064
)
 
$
2,393

 
$
1,329

The tax effects allocated to each component of other comprehensive loss for the nine months ended September 30, 2018 were as follows (in thousands):
 
Before-Tax Amount
 
Tax Expense
 
Net-of-Tax Amount
Foreign currency translation adjustments
$
(36,541
)
 
$

 
$
(36,541
)
Unrealized gain on derivative instruments:
 
 
 
 
 
Unrealized gain arising during period
2,178

 
(466
)
 
1,712

Reclassification adjustment of realized gains to net loss
(362
)
 
(9
)
 
(371
)
Net unrealized gain on derivative instruments
1,816

 
(475
)
 
1,341

Other comprehensive loss
$
(34,725
)
 
$
(475
)
 
$
(35,200
)

11






The tax effects allocated to each component of other comprehensive income for the three months ended September 30, 2017 were as follows (in thousands):
 
Before-Tax Amount
 
Tax (Expense) or Benefit
 
Net-of-Tax Amount
Foreign currency translation adjustments
$
10,499

 
$
(5,873
)
 
$
4,626

Unrealized gain on derivative instruments:
 
 
 
 
 
Unrealized gain arising during period
34

 
(14
)
 
20

Reclassification adjustment for gains realized in net loss
(221
)
 
86

 
(135
)
Net unrealized loss on derivative instruments
(187
)
 
72

 
(115
)
Other comprehensive income
$
10,312

 
$
(5,801
)
 
$
4,511

The tax effects allocated to each component of other comprehensive income for the nine months ended September 30, 2017 were as follows (in thousands):
 
Before-Tax Amount
 
Tax Expense
 
Net-of-Tax Amount
Foreign currency translation adjustments
$
22,831

 
$
(5,873
)
 
$
16,958

Unrealized gain on derivative instruments:
 
 
 
 
 
Unrealized gain arising during the period
67

 
(21
)
 
46

Reclassification adjustment of realized gains to net loss
(478
)
 
184

 
(294
)
Net unrealized loss on derivative instruments
(411
)
 
163

 
(248
)
Other comprehensive income
$
22,420

 
$
(5,710
)
 
$
16,710

Other (Expense) Income, Net
Other (expense) income, net consisted of the following (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Net realized foreign currency gain (loss)
$
1,978

 
$
(5,147
)
 
$
2,146

 
$
(9,298
)
Net unrealized foreign currency (loss) gain
(4,706
)
 
(381
)
 
14,927

 
(6,264
)
Other, net
(1,618
)
 
(425
)
 
(1,972
)
 
(602
)
Total other (expense) income, net
$
(4,346
)
 
$
(5,953
)
 
$
15,101

 
$
(16,164
)
3 . Business Combinations
inVentiv Health Merger
On August 1, 2017 (the “Merger Date”), the Company completed the Merger with inVentiv with the Company surviving as the accounting and legal entity acquirer. The Merger was accounted for as a business combination using the acquisition method of accounting in accordance with ASC Topic 805, Business Combinations . The purchase price has been allocated to the tangible assets and identifiable intangible assets acquired and liabilities assumed based upon their fair values. The excess of the purchase price over the tangible and intangible assets acquired and liabilities assumed has been recorded as goodwill. The goodwill in connection with the Merger is primarily attributable to the assembled workforce of inVentiv and the expected synergies of the Merger.
In connection with the Merger, the Company assumed certain contingent tax-sharing obligations of inVentiv. The fair value of the contingent tax-sharing liability is remeasured at the end of each reporting period, with changes in the estimated fair value reflected in earnings until the liability is fully settled. The estimated fair value of the contingent tax-sharing obligation liability was $54.1 million and $50.5 million as

12






of September 30, 2018 and December 31, 2017 , respectively. The liability is included in the “Accrued liabilities” and “Other long-term liabilities” line items of the accompanying unaudited condensed consolidated balance sheets.
The results of inVentiv’s operations have been included in the Company’s statements of operations since the Merger Date. Computing separate measures of inVentiv’s stand-alone revenue and profitability for the period after the Merger Date is impracticable.
Allocation of Consideration Transferred
The fair value of the consideration transferred on the Merger Date was $4.51 billion . The following table summarizes the allocation of the consideration transferred based on management’s estimates of Merger Date fair values of assets acquired and liabilities assumed, with the excess of the purchase price over the estimated fair values of the identifiable net assets acquired recorded as goodwill (in thousands):     
Assets acquired:
 
Cash and cash equivalents
$
57,338

Restricted cash
433

Accounts receivable
367,595

Unbilled accounts receivable
262,944

Other current assets
97,922

Property and equipment
114,041

Intangible assets
1,334,200

Other assets
50,052

Total assets acquired
2,284,525

Liabilities assumed:
 
Accounts payable
38,072

Accrued liabilities
304,341

Contract liabilities
247,474

Capital leases
40,928

Long-term debt, current and non-current
737,872

Deferred income taxes, net
14,751

Other liabilities
119,480

Total liabilities assumed
1,502,918

Total identifiable assets acquired, net
781,607

Goodwill
$
3,724,016

The goodwill recognized in connection with the Merger was $3.72 billion , with $2.23 billion of the goodwill assigned to the Clinical Solutions segment and $1.49 billion assigned to the Commercial Solutions segment. Goodwill generated in the Merger is not deductible for income tax purposes. During the nine months ended September 30, 2018 , the Company made adjustments to the preliminary fair value of acquired assets and assumed liabilities to reflect additional information obtained in connection with the Merger. The net effect of these adjustments resulted in a $9.5 million decrease in goodwill.

13






Unaudited Pro Forma Financial Information
The following unaudited pro forma financial information was derived from the historical financial statements of the Company and inVentiv and presents the combined results of operations as if the Merger had occurred on January 1, 2016. The pro forma financial information is presented for comparative purposes only and is not necessarily indicative of the results that would have actually occurred had the Merger been completed on January 1, 2016. In addition, the unaudited pro forma financial information does not give effect to any anticipated cost savings, operating efficiencies or other synergies that may result from the Merger, or any estimated costs that have been or will be incurred by the Company to integrate the assets and operations of inVentiv. Consequently, actual future results of the Company will differ from the unaudited pro forma financial information presented.
 
Three Months Ended September 30, 2017
 
Nine Months Ended September 30, 2017
 
(In thousands, except per share data)
Pro forma total revenue
$
1,025,942

 
$
3,145,253

Pro forma net loss
(85,223
)
 
(77,925
)
Pro forma loss per share:
 
 
 
   Basic
$
(0.82
)
 
$
(0.75
)
   Diluted
$
(0.82
)
 
$
(0.75
)
The unaudited pro forma adjustments primarily relate to the depreciation of acquired property and equipment, amortization of acquired intangible assets and interest expense and amortization of deferred financing costs related to the new financing arrangements. In addition, the unaudited pro forma net loss for the three and nine months ended   September 30, 2017  was adjusted to exclude $68.2 million and $90.9 million , respectively, net of tax effects, of nonrecurring merger-related transaction costs.
Kinapse Limited Acquisition
In August 2018, the Company completed its acquisition of Kinapse Topco Limited (“Kinapse”), a provider of advisory and operational solutions to the global life sciences industry. The total purchase consideration was $100.1 million plus assumed debt and includes cash acquired of $4.9 million . The Company recognized $83.4 million of goodwill and $57.3 million of intangible assets, principally customer relationships, as a result of the acquisition. The goodwill is not deductible for income tax purposes. The Company’s assessment of fair value and the purchase price allocation related to this acquisition is preliminary and further adjustments may be necessary as additional information related to the fair values of assets acquired and liabilities assumed is assessed during the measurement period (up to one year from the acquisition date).
The operating results from the Kinapse acquisition have been included in the Company’s Commercial Solutions segment from the date of acquisition. The unaudited pro forma financial information was not updated to include this acquisition as the impact would have been insignificant.

14






4 . Long-Term Debt Obligations
The Company’s debt obligations consisted of the following (in thousands):
 
September 30, 2018
 
December 31, 2017
Secured Debt
 
 
 
Term Loan A due August 2022
$
981,250

 
$
1,000,000

Term Loan B due August 2024
1,251,000

 
1,550,000

Revolving credit facility due August 2022

 

Accounts receivable financing agreement due June 2020
183,600

 

Total secured debt
2,415,850

 
2,550,000

Unsecured Debt
 
 
 
7.5% Senior Unsecured Notes due 2024
403,000

 
403,000

Total debt obligations
2,818,850

 
2,953,000

Add: unamortized Senior Notes premium, net of original issue debt discount
33,360

 
38,656

Less: unamortized deferred issuance costs
(14,529
)
 
(20,722
)
Less: current portion of debt
(62,050
)
 
(25,000
)
Total debt obligations, non-current portion
$
2,775,631

 
$
2,945,934

During the nine months ended September 30, 2018 , the Company voluntarily prepaid $299.0 million towards reducing its outstanding Term Loan B balance, which was applied against the regularly-scheduled quarterly principal payments. As a result, the Company is not required to make a mandatory payment against the Term Loan B principal balance until maturity in August 2024. Additionally, during the nine months ended September 30, 2018 , the Company made mandatory principal repayments of $18.8 million towards its Term Loan A and settled $36.6 million of debt upon the closing of an acquisition.

Repricing Amendment to Credit Agreement
On  May 4, 2018 , the Company entered into Amendment No. 1 (the “Repricing Amendment”) to the Credit Agreement dated August 1, 2017 (the “2017 Credit Agreement”), which, among other things, modified the terms of the 2017 Credit Agreement to: (i) reduce by 0.25% overall the applicable margins for alternate base rate (“Base Rate”) loans and Adjusted Eurocurrency Rate (“Eurocurrency Rate”) loans with respect to both Term Loan A and Term Loan B; and (ii) reset the period in which a prepayment premium with respect to Term Loan B is required for a “Repricing Transaction” (as defined in the Credit Agreement) to six months after the closing date of the Repricing Amendment.
The applicable margins with respect to Base Rate and Eurocurrency Rate borrowings are determined depending on the “First Lien Leverage Ratio” or the "Secured Net Leverage Ratio" (as defined in the Repricing Amendment) and range as follows:
 
Base Rate
 
Eurocurrency Rate
Term Loan A
0.25
%
-
0.50%
 
1.25
%
-
1.50%
Term Loan B
0.75
%
-
1.00%
 
1.75
%
-
2.00%
Accounts Receivable Financing Agreement
On June 29, 2018 the Company entered into an accounts receivable financing agreement ( as amended) with a termination date of June 29, 2020, unless terminated earlier pursuant to its terms. Under this agreement, certain of the Company’s consolidated subsidiaries will sell accounts receivable and unbilled services (including contract assets) balances to a wholly-owned, bankruptcy-remote special purpose entity (“SPE”). The SPE can borrow up to  $250.0 million  from a third-party lender, secured by liens on certain receivables and other assets of the SPE. The Company has guaranteed the performance of the obligations of existing and future subsidiaries that sell and service the accounts receivable under this

15






agreement. The available borrowing capacity varies monthly according to the levels of the Company’s eligible accounts receivable and unbilled receivables. Loans under this agreement will accrue interest at a reserve-adjusted LIBOR rate or a base rate equal to the highest of (i) the applicable lender’s prime rate, and (ii) the federal funds rate plus 0.50% . The Company may prepay loans upon one business day prior notice and may terminate or reduce the facility limit of the accounts receivable financing agreement with 15 days ’ prior notice.
As of September 30, 2018 , the Company had $183.6 million of outstanding borrowings under the accounts receivable financing agreement, which is recorded in the “Current portion of long term debt” and “Long term debt, noncurrent” line items on the accompanying unaudited condensed consolidated balance sheet. The remaining maximum capacity available for borrowing under this agreement was $66.4 million as of September 30, 2018 .
5 . Derivative Financial Instruments
In May 2016, the Company entered into interest rate swaps with a combined notional value of $300.0 million  in an effort to limit its exposure to variable interest rates on its Term Loans. Interest began accruing on the swaps on June 30, 2016 and a portion of the interest rate swaps expired on June 30, 2018, with the remainder expiring on May 14, 2020. As of September 30, 2018 , the remaining notional value of these interest rate swaps was $100.0 million .
In June 2018, the Company entered into  two new interest rate swaps with multiple counterparties in an effort to limit its exposure to variable interest rates on its Term Loans. The first interest rate swap has an aggregate notional value of $1.22 billion , began accruing interest on June 29, 2018, and will expire on December 31, 2018. As of September 30, 2018 , the remaining notional value of this interest rate swap was $1.07 billion . The second interest rate swap has an aggregate notional value of $1.01 billion , an effective date of December 31, 2018, and will expire on June 30, 2021. 
The material terms of these derivatives are substantially the same as those contained within the 2017 Credit Agreement, including monthly settlements with the swap counterparty. Interest rate swaps are designated as hedging instruments. The amounts of hedge ineffectiveness recorded in net loss during the three and nine months ended September 30, 2018 and September 30, 2017 were insignificant and were attributable to inconsistencies in certain terms between the interest rate swaps and the 2017 Credit Agreement.
The Company became a party to certain foreign currency exchange rate forward contracts as a result of an acquisition that have expiration dates through April 2019. During the three and nine months ended September 30, 2018 , the amount of loss recognized in other income (expense), net with respect to these contracts was inconsequential.
The fair values of the Company’s derivative financial instruments and the line items on the accompanying unaudited condensed consolidated balance sheets to which they were recorded are as follows (in thousands):
 
Balance Sheet Classification
 
September 30, 2018
 
December 31, 2017
Foreign currency exchange rate swaps - current
Prepaid expenses and other current assets
 
$
138

 
$

Interest rate swaps - current
Prepaid expenses and other current assets
 
$
1,640

 
$
916

Interest rate swaps - non-current
Other long-term assets
 
$
3,365

 
$
1,263

Interest rate swaps - current
Accrued liabilities
 
$
(1,028
)
 
$


16






6 . Fair Value Measurements
Assets and Liabilities Carried at Fair Value
As of September 30, 2018 and December 31, 2017 , the Company’s financial assets and liabilities carried at fair value included cash and cash equivalents, restricted cash, trading securities, billed and unbilled accounts receivable, contract assets, accounts payable, accrued liabilities, contract liabilities, assumed contingent obligations, capital leases, liabilities under the accounts receivable financing agreement, and derivative instruments.
The fair value of cash and cash equivalents, restricted cash, billed and unbilled accounts receivable, contract assets, accounts payable, accrued liabilities, contract liabilities, and the liabilities under the accounts receivable financing agreement approximates their respective carrying amounts because of the liquidity and short-term nature of these financial instruments.
Financial Instruments Subject to Recurring Fair Value Measurements

As of September 30, 2018 , the fair values of the major classes of the Company’s assets and liabilities measured at fair value on a recurring basis were as follows (in thousands):
 
Level 1
 
Level 2
 
Level 3
 
Total
Assets:
 
 
 
 
 
 
 
Trading securities
$
17,113

 
$

 
$

 
$
17,113

Derivative instruments

 
5,143

 

 
5,143

Total assets
$
17,113

 
$
5,143

 
$

 
$
22,256

 
 
 
 
 
 
 
 
Liabilities:
 
 
 
 
 
 
 
Derivative instruments
$

 
$
1,028

 
$

 
$
1,028

Contingent obligations related to business combinations

 

 
58,530

 
58,530

Total liabilities
$

 
$
1,028

 
$
58,530

 
$
59,558


17






As of December 31, 2017 , the fair values of the major classes of the Company’s assets and liabilities measured at fair value on a recurring basis were as follows (in thousands):
 
Level 1
 
Level 2
 
Level 3
 
Total
Assets:
 
 
 
 
 
 
 
Trading securities
$
16,318

 
$

 
$

 
$
16,318

Derivative instruments

 
2,179

 

 
2,179

Total assets
$
16,318

 
$
2,179

 
$

 
$
18,497

 
 
 
 
 
 
 
 
Liabilities:
 
 
 
 
 
 
 
Contingent obligations related to business combinations
$

 
$

 
$
50,480

 
$
50,480

Total liabilities
$

 
$

 
$
50,480

 
$
50,480

The following table presents changes in the carrying amount of obligations classified as Level 3 category within the fair value hierarchy for the nine months ended September 30, 2018 (in thousands):
Balance at December 31, 2017
$
50,480

Additions
4,353

Changes in fair value recognized in earnings
3,697

Balance at September 30, 2018
$
58,530

During the nine months ended September 30, 2018 , there were no transfers of assets or liabilities between Level 1, Level 2 or Level 3 fair value measurements.
Financial Instruments Subject to Non-Recurring Fair Value Measurements
Certain assets, including goodwill and identifiable intangible assets, are carried on the balance sheets at cost and, subsequent to initial recognition, are measured at fair value on a non-recurring basis when certain identified events or changes in circumstances that may have a significant adverse effect on the carrying values of these assets occur. These assets are classified as Level 3 fair value measurements within the fair value hierarchy. Goodwill is tested for impairment annually or more frequently if events or changes in circumstances indicate a triggering event has occurred. Intangible assets are tested for impairment upon the occurrence of certain triggering events. As of September 30, 2018 and December 31, 2017 , assets subject to non-recurring fair value measurements totaled $5.54 billion and $5.58 billion , respectively.
Fair Value Disclosures for Debt Not Carried at Fair Value
The estimated fair value of the outstanding term loans and Senior Unsecured Notes is determined based on the price that the Company would have to pay to settle the liabilities. As these liabilities are not actively traded, they are classified as Level 2 fair value measurements. The estimated fair values of the Company’s outstanding term loans and Senior Unsecured Notes were as follows (in thousands):
 
September 30, 2018
 
December 31, 2017
 
Carrying Value (a)
 
Estimated Fair Value
 
Carrying Value (a)
 
Estimated Fair Value
Term Loan A due August 2022
$
979,333

 
$
981,250

 
$
1,000,000

 
$
1,000,000

Term Loan B due August 2024
$
1,249,673

 
$
1,251,000

 
$
1,548,149

 
$
1,550,000

7.5% Senior Unsecured Notes due 2024
$
439,604

 
$
429,195

 
$
443,507

 
$
433,729

(a) The carrying value of the term loan debt is shown net of original issue debt discounts. The carrying value of the 7.5% Senior Unsecured Notes is inclusive of unamortized premiums.

18






7 . Restructuring and Other Costs
Merger-Related Restructuring
In connection with the Merger, the Company established a restructuring plan to eliminate redundant positions and reduce its facility footprint worldwide. The Company expects to continue the ongoing evaluations of its workforce and facilities infrastructure needs through 2020 in an effort to optimize its resources. During the nine months ended September 30, 2018 , the Company recognized approximately: (i) $13.2 million of employee severance and benefits related costs; (ii) $20.6 million of facility closure and lease termination costs; and (iii) $0.5 million of other costs related to the Merger. Over the next several years, the Company expects to incur significant costs related to the restructuring of its operations in order to achieve targeted synergies from the Merger. The timing and the amount of these costs and related benefits may differ significantly from current management’s estimates and depends on various factors, including, but not limited to, identifying and realizing synergy opportunities and executing the integration of the Company’s operations.
Other Restructuring
During the nine months ended September 30, 2018 , the Company incurred $1.4 million of facility closure and lease termination costs related to the Company’s pre-Merger activities aimed at optimizing its resources worldwide. Additionally, during the  nine months ended September 30, 2018 , the Company recognized: (i) approximately $3.2 million  of consulting costs related to the restructuring of its contract management processes to meet the requirements of the newly adopted revenue recognition accounting standard; (ii) $1.7 million of employee severance and benefits related costs; and (iii) $1.0 million of other restructuring costs.
Accrued Restructuring Liabilities
The following table summarizes activity related to the liabilities associated with restructuring and other costs during the nine months ended September 30, 2018 (in thousands):
 
Employee Severance Costs, Including Executive Transition Costs
 
Facility Closure and Lease Termination Costs
 
Other Costs
 
Total
Balance at December 31, 2017
$
8,858

 
$
7,411

 
$
524

 
$
16,793

Expenses incurred (a)
14,829

 
18,633

 
4,148

 
37,610

Cash payments made
(18,208
)
 
(5,301
)
 
(4,594
)
 
(28,103
)
Balance at September 30, 2018
$
5,479

 
$
20,743

 
$
78

 
$
26,300

(a) The amount of expenses incurred presented in the reconciliation of accrued restructuring liabilities excludes $4.0 million of non-cash restructuring and other expenses incurred for the nine months ended September 30, 2018 because these expenses were not subject to accrual prior to the period in which they were incurred.
The Company expects that substantially all of the employee severance costs accrued as of September 30, 2018 will be paid within the next twelve months. Certain facility costs will be paid over the remaining terms of exited facility leases, which range from 2018 through 2027. Liabilities associated with these costs are included in the “Accrued liabilities” and “Other long-term liabilities” line items in the accompanying unaudited condensed consolidated balance sheets. Restructuring and other costs included in net loss for the three and nine months ended September 30, 2018 are presented in the “Restructuring and other costs” line item in the unaudited condensed consolidated statements of operations.

19






8 . Shareholders' Equity
2018 Stock Repurchase Program
On February 26, 2018, the Company’s Board of Directors authorized the repurchase of up to an aggregate of $250.0 million  of the Company’s common stock, par value $0.01 per share, to be executed from time to time in open market transactions effected through a broker at prevailing market prices, in block trades or through privately negotiated transactions (“2018 stock repurchase program”). The 2018 stock repurchase program commenced on March 1, 2018 and will end no later than December 31, 2019. The Company intends to use cash on hand and future operating cash flow to fund the stock repurchase program.
The 2018 stock repurchase program does not obligate the Company to repurchase any particular amount of the Company’s common stock and may be modified, extended, suspended, or discontinued at any time. The timing and amount of repurchases will be determined by the Company’s management based on a variety of factors such as the market price of the Company’s common stock, the Company’s corporate requirements for cash, and overall market conditions. The stock repurchase program will be subject to applicable legal requirements, including federal and state securities laws. The Company may also repurchase shares of its common stock pursuant to a trading plan meeting the requirements of Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, which would permit shares of the Company’s common stock to be repurchased when the Company might otherwise be precluded from doing so by law.
In March 2018, the Company repurchased 948,100 shares of its common stock in open market transactions at an average price of $39.55 per share, resulting in a total purchase price of approximately  $37.5 million . In April 2018, the Company repurchased 1,024,400 shares of its common stock in open market transactions at an average price of $36.60 per share, resulting in a total purchase price of approximately  $37.5 million . The Company immediately retired all of the repurchased common stock and charged the par value of the shares to common stock. The excess of the repurchase price over par was applied on a pro rata basis against additional paid-in-capital, with the remainder applied to accumulated deficit.
As of  September 30, 2018 , the Company has remaining authorization to repurchase up to approximately $175.0 million  of shares of its common stock under the 2018 stock repurchase program.
9 . Share-Based Compensation
Restricted Stock Unit Award Activity
The following table summarizes the Restricted Stock Unit (“RSU”) activity during the nine months ended September 30, 2018 :
 
Number of Shares
 
Weighted Average
Grant Date Fair Value
Non-vested at December 31, 2017
907,580

 
$
49.30

Granted
1,897,581

 
$
38.55

Vested
(242,315
)
 
$
48.53

Forfeited
(295,697
)
 
$
45.10

Non-vested at September 30, 2018
2,267,149

 
$
40.93

At  September 30, 2018 , total unrecognized compensation expense related to unvested RSUs was  $67.4 million , which is expected to be recognized over a weighted average period of  2.2 years .

20






2018 Performance-Based RSU Awards
During 2018, the Compensation Committee of the Company’s Board of Directors granted performance-based RSU awards (“PRSUs”) to certain executive officers. The total target number of PRSUs granted was  198,382  which will vest in a percentage ranging from 0% to 150% depending on the level of achievement of the performance targets. Each award is scheduled to cliff-vest approximately three years from the grant date and consists of three equal tranches with each tranche being conditional upon: (i) the attainment of performance targets related to the Company’s revenue growth for fiscal years 2018, 2019, and 2020; and (ii) the continued employment and service of the employee from the grant date through the date when determination of the target attainment level for the last performance period is made. The Company recognizes share-based compensation expense for PRSUs when attainment of each performance target becomes probable.

Share-based Compensation Expense
The total amount of share-based compensation expense recognized in the unaudited condensed consolidated statements of operations was as follows (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
Statement of Operations Classification
2018
 
2017
 
2018
 
2017
Direct costs
$
5,216

 
$
5,388

 
$
14,540

 
$
11,055

Selling, general, and administrative expenses
4,575

 
2,165

 
11,414

 
8,546

Restructuring and other costs

 

 
91

 

Transaction and integration-related expenses

 
31,327

 

 
31,327

Total share-based compensation expense
$
9,791

 
$
38,880

 
$
26,045

 
$
50,928

10 . Earnings Per Share
Basic earnings per share is computed based on the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed based on the weighted average number of common shares outstanding plus the effect of dilutive potential common shares outstanding during the period. A reconciliation of the numerators and denominators of the basic and diluted per share computations of weighted average common shares outstanding based on the Company’s consolidated net loss is as follows (in thousands, except per share amounts):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Numerator:
 
 
 
 
 
 
 
Net loss
$
(10,394
)
 
$
(147,998
)
 
$
(21,386
)
 
$
(123,422
)
Denominator:
 
 
 
 
 
 
 
Basic weighted average common shares outstanding
103,012

 
87,152

 
103,453

 
65,097

Effect of dilutive securities:
 
 
 
 
 
 
 
Stock options and other awards under deferred share-based compensation programs

 

 

 

Diluted weighted average common shares outstanding
103,012

 
87,152

 
103,453

 
65,097

Loss per share:
 
 
 
 
 
 
 
Basic
$
(0.10
)
 
$
(1.70
)
 
$
(0.21
)
 
$
(1.90
)
Diluted
$
(0.10
)
 
$
(1.70
)
 
$
(0.21
)
 
$
(1.90
)

21






Potential common shares outstanding that are considered antidilutive are excluded from the computation of diluted earnings per share. Potential common shares related to stock options and other awards under deferred share-based compensation programs may be determined to be antidilutive based on the application of the treasury stock method. Potential common shares are also considered antidilutive in the event of a net loss from operations.
The number of potential shares outstanding that were considered antidilutive using the treasury stock method and therefore excluded from the computation of diluted earnings per share, weighted for the portion of the period they were outstanding are as follows (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Anti-dilutive stock options and other awards
335

 
126

 
1,224

 
488

Anti-dilutive stock options and other awards under deferred share-based compensation programs excluded based on reporting a net loss for the period
1,621

 
1,534

 
1,208

 
1,275

Total common stock equivalents excluded from diluted earnings per share computation
1,956

 
1,660

 
2,432

 
1,763

11 . Income Taxes
Income Tax Expense
For the three and nine months ended September 30, 2018 , the Company recorded income tax expense of $12.0 million and $19.1 million , compared to pre-tax income of $1.6 million and pre-tax loss of $2.3 million , respectively. The effective tax rate for the three and nine months ended September 30, 2018 varied from the U.S. federal statutory income tax rate of 21.0% primarily due to: (i) the recognition of unfavorable discrete adjustments related to foreign currency exchange; (ii) the geographical split of pre-tax income; and (iii) deferred expense related to hanging credits on domestic indefinite-lived intangibles.
For the three and nine months ended September 30, 2017 , the Company recorded an income tax expense of $26.1 million and $30.2 million , respectively, compared to pre-tax losses of  $121.9 million  and  $93.2 million , respectively. The Company’s effective tax rate for the  three and nine months ended September 30, 2017  varied from the U.S. federal statutory income tax rate of 35.0% primarily due to: (i) a discrete tax expense related to a change in the Company’s method of accounting for undistributed foreign earnings; (ii) the relative amount of income from operations earned in international jurisdictions with lower statutory income tax rates than the United States; and (iii) discrete tax adjustments related to excess tax benefits on share-based compensation. 
Unrecognized Tax Benefits
The Company's gross unrecognized tax benefits, exclusive of associated interest and penalties, were  $19.7 million and $43.7 million  as of  September 30, 2018  and  December 31, 2017 , respectively. The decrease of $24.0 million was primarily due to: (i) audit settlements in the United States and foreign jurisdictions, of which $1.4 million decreased tax expense; and (ii) remeasurement of acquired positions in relation to the Merger with inVentiv. The Company anticipates that during the next 12 months the unrecognized tax benefits will decrease by approximately $0.1 million .

22






Tax Cuts and Jobs Act of 2017
On December 22, 2017, the U.S. government enacted comprehensive tax legislation commonly referred to as the Tax Cuts and Jobs Act (“Tax Act”). The Tax Act made broad and complex changes to the U.S. tax code, including requiring companies to pay a one-time transition tax on certain undistributed earnings of foreign subsidiaries. The deemed repatriation transition tax (“Transition Tax”) is a tax on previously untaxed accumulated and current earnings and profits (“E&P”) of the Company’s foreign subsidiaries. The Company was able to reasonably estimate the Transition Tax and recorded a provisional tax expense of $63.1 million for the year ended December 31, 2017 . During the nine months ended September 30, 2018 , the Company completed its accounting for the effects of the Transition Tax, with the exception of the state tax effects. On the basis of revised E&P computations that were completed during the reporting period, the final Transition Tax is $61.5 million . Due to the valuation allowance on the federal deferred tax assets, this decrease in the Transition Tax did not affect the 2018 effective tax rate for the period.
12 . Revenue from Contracts with Customers
Service Revenue
The Company adopted ASC 606 - Revenue from Contracts with Customers and all related amendments (“new revenue standard” or “ASC 606”) on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the three and nine months ended September 30, 2018 reflect the application of ASC 606, while the reported results for the three and nine months ended September 30, 2017 were prepared under ASC 605 - Revenue Recognition and other authoritative guidance in effect for those periods. In accordance with ASC 606, revenue is now recognized when, or as, a customer obtains control of promised services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these services.
A performance obligation is a promise (or a combination of promises) in a contract to transfer distinct goods or services to a customer and is the unit of accounting under ASC 606 for the purposes of revenue recognition. A contract’s transaction price is allocated to each separate performance obligation based upon the standalone selling price and is recognized as revenue, when, or as, the performance obligation is satisfied. The majority of the Company’s contracts have a single performance obligation because the promise to transfer individual services is not separately identifiable from other promises in the contracts, and therefore, is not distinct. For contracts with multiple performance obligations, the contract’s transaction price is allocated to each performance obligation using the best estimate of the standalone selling price of each distinct good or service in the contract.
The majority of the Company's revenue arrangements are service contracts that range in duration from a few months to several years. Substantially all of the Company’s performance obligations, and associated revenue, are transferred to the customer over time. The Company generally receives compensation based on measuring progress toward completion using anticipated project budgets for direct labor and prices for each service offering. The Company is also reimbursed for certain third party pass-through and out-of-pocket costs. In addition, in certain instances a customer contract may include forms of variable consideration such as incentive fees, volume rebates or other provisions that can increase or decrease the transaction price. This variable consideration is generally awarded upon achievement of certain performance metrics, program milestones or cost targets. For the purposes of revenue recognition, variable consideration is assessed on a contract-by-contract basis and the amount to be recorded is estimated based on the assessment of the Company’s anticipated performance and consideration of all information that is reasonably available. Variable consideration is recognized as revenue if and when it is deemed probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved in the future.
Most of the Company's contracts can be terminated by the customer without cause with a 30 -day notice. In the event of termination, the Company's contracts generally provide that the customer pay the Company for: (i) fees earned through the termination date; (ii) fees and expenses for winding down the

23






project, which include both fees incurred and actual expenses; (iii) non-cancellable expenditures; and (iv) in some cases, a fee to cover a portion of the remaining professional fees on the project. The Company’s long term clinical trial contracts contain implied substantive termination penalties because of the significant wind-down cost of terminating a clinical trial. These provisions for termination penalties result in these types of contracts being treated as long-term for revenue recognition purposes.
Changes in the scope of work are common, especially under long-term contracts, and generally result in a renegotiation of future contract pricing terms and change in contract transaction price. If the customer does not agree to a contract modification, the Company could bear the risk of cost overruns. Most of the Company’s contract modifications are for services that are not distinct from the services under the existing contract due to the significant integration service provided in the context of the contract and therefore result in a cumulative catch-up adjustment to revenue at the date of contract modification.
Contract Assets and Liabilities
Contract assets include unbilled amounts typically resulting from revenue recognized in excess of the amounts billed to the customer for which the right to payment is subject to factors other than the passage of time. These amounts may not exceed their net realizable value. Contract assets are generally classified as current. Contract liabilities consist of customer payments received in advance of performance and billings in excess of revenue recognized, net of revenue recognized from the balance at the beginning of the period. Contract assets and liabilities are presented on the balance sheet on a net contract-by-contract basis at the end of each reporting period.
Capitalized Costs
The Company capitalizes certain costs associated with commissions and bonuses paid to its employees in the Clinical Solutions segment because these costs are incurred in obtaining contracts that have a term greater than one year. Capitalized costs are included in the “Prepaid expenses and other current assets” and “Other long-term assets” line items of the accompanying unaudited condensed consolidated balance sheets. The Company amortizes these costs in a manner that is consistent with the pattern of revenue recognition described below. The Company expenses obtainment costs for contracts that have a term of one year or less.
Additionally, certain recruiting and training costs within the selling solutions services offering are incurred prior to deployment of the contract field promotion teams that are reimbursed by the customer. These costs are capitalized and amortized ratably from the deployment date through the end of the accounting contract term. Capitalized costs and the related amortization are as follows (in thousands):
 
September 30, 2018
Capitalized costs incurred to obtain or fulfill contracts with customers
$
19,003

 
Three Months Ended September 30, 2018
 
Nine Months Ended September 30, 2018
Amortization of capitalized costs
$
5,209

 
$
12,911

Clinical Solutions
The Company’s Clinical Solutions segment provides solutions to address the clinical development needs of customers. The Company provides biopharmaceutical program development services through the Full Service Clinical Development (“Full Service”) platform, discrete services for any part of a customer clinical trial through a Functional Service Provider (“FSP”) offering, Early Stage services, and Real World and Late Phase (“RWLP”) services. The services provided via the Full Service and RWLP platforms generally span several years and a significant benefit to the customer is provided by integrating those services provided by the Company’s employees as well as those performed by third parties.

24






Because the Company provides a significant benefit to the customer of integrating the services provided by the Full Service offering, there is one performance obligation for revenue recognition purposes. Revenue is recognized over time using an input measure of progress. The input measure reflects costs (including investigator payments and pass-through costs) incurred to date relative to total estimated costs to complete (“cost-to-cost measure of progress”). Under the cost-to-cost measure of progress methodology, revenue is recorded proportionally to costs incurred. Contract costs principally include direct labor, investigator payments, and pass-through costs.
The remaining service offerings within the Clinical Solutions segment are generally short-term, month-to-month contracts, time and materials basis contracts, or provide a series of distinct services that are substantially the same and have the same pattern of transfer to the customer (“series”). As such, revenue for these service offerings is generally recognized as services are performed for the amount the Company estimates it is entitled to for the period, similar to the pattern of recognition under ASC 605. For contracts billed on a fixed price basis, revenue is recognized over time based on the proportion of labor costs expended to total labor costs expected to complete the contract performance obligation.
The estimate of total revenue and costs at completion requires significant judgment. Contract estimates are based on various assumptions to project future outcomes of events that often span several years. These estimates are reviewed periodically and any adjustments are recognized on a cumulative catch up basis in the period they become known.
Unsatisfied Performance Obligations
As of September 30, 2018 , the total aggregate transaction price allocated to the unsatisfied performance obligations under contracts with a contract term greater than one year and which are not accounted for as a series pursuant to ASC 606 was $5.22 billion . This amount includes revenue associated with reimbursable out-of-pocket expenses. The Company expects to recognize revenue over the remaining contract term of the individual projects, with contract terms generally ranging from  one  to  five  years. The amount of unsatisfied performance obligations is presented net of any constraints and as a result, is lower than the potential contractual revenue. Specifically, contracts that do not commence within a certain period of time require the Company to undertake numerous activities to fulfill these performance obligations, including various activities that are outside of the Company’s control. Accordingly, such contracts have been excluded from the unsatisfied performance obligations balance presented above.
Commercial Solutions
The Company’s Commercial Solutions segment provides a broad suite of complementary commercialization services including selling solutions, communications (advertising and public relations), and consulting services. The largest of the service offerings within the Commercial Solutions segment relates to selling solutions. Selling solutions contracts are comprised of a single performance obligation that represents a series of daily outsourced detailing services to promote and sell commercial products on behalf of a customer.
The remaining Commercial Solutions contracts are generally short-term, month-to-month contracts or time and materials contracts. As such, Commercial Solutions revenue is generally recognized as services are performed for the amount the Company estimates it is entitled to for the period, similar to the pattern of recognition under ASC 605. For contracts billed on a fixed price basis, revenue is recognized over time based on the proportion of labor costs expended to total labor costs expected to complete the contract performance obligation.
Pass-through and out-of-pocket costs are recognized in service revenue in the unaudited condensed consolidated income statement as incurred. Certain media purchases and the related reimbursements are recorded on a net basis in the unaudited condensed consolidated income statement as such activities are controlled by the customer.

25






The Commercial Solutions segment does not have material unsatisfied performance obligations that are required to be disclosed under ASC 606 because the contracts are short-term in nature or represent a series pursuant to ASC 606.
Timing of Billing and Performance
Differences in the timing of revenue recognition and associated billings and cash collections result in recording of billed accounts receivable, unbilled accounts receivable, contract assets and contract liabilities on the unaudited condensed consolidated balance sheet. Amounts are billed as work progresses in accordance with agreed-upon contractual terms either at periodic intervals or upon achievement of contractual milestones. Billings generally occur subsequent to revenue recognition, resulting in recording of: (i) unbilled accounts receivable in instances where the right to bill is contingent solely on the passage of time (e.g., in the following month); and (ii) contract assets in instances where the right to bill is associated with a contingency (e.g., achievement of a milestone). Cash payments received in advance of the Company’s performance result in recording of contract liabilities, which are liquidated as revenue is recognized.
Contract assets and liabilities are recorded net on a contract-by-contract basis at the end of each reporting period.
During the three and nine months ended September 30, 2018 , the Company recognized approximately $363.7 million and $481.8 million , respectively, of revenue that was included in the contract liabilities balance at the beginning of the period. In order to determine revenue recognized in the period from contract liabilities, the Company first allocates revenue to the individual contract liability balance outstanding at the beginning of the period until the revenue exceeds that balance. During the three and nine months ended September 30, 2018 , approximately $2.9 million and $(6.1) million of the Company’s revenue recognized was allocated to performance obligations partially satisfied in previous periods and predominately related to changes in scope and estimates in full service clinical studies. Changes in the contract assets and liabilities balances during the three and nine months ended September 30, 2018 were not materially impacted by any other factors.
Impact of Adopting ASC 606
The Company adopted ASC 606 using the modified retrospective method. The cumulative effect of applying the new guidance to all contracts with customers that were not completed as of January 1, 2018 was recorded as an adjustment to accumulated deficit as of the adoption date, with the impact primarily related to the performance obligations related to the Full Service customer clinical trials in the Clinical Solutions segment.

26






As a result of applying the modified retrospective method to adopt the new accounting guidance, the following adjustments were made to the unaudited condensed consolidated balance sheet as of January 1, 2018 (in thousands):
 
As Reported
 
Adjustments
 
Adjusted
 
December 31, 2017
 
ASC 606 Adoption
 
January 1, 2018
ASSETS
 
 
 
 
 
Current assets:
 
 
 
 
 
Cash and cash equivalents
$
321,262

 
$

 
$
321,262

Restricted cash
714

 

 
714

Accounts receivable billed, net
642,985

 

 
642,985

Accounts receivable unbilled
373,003

 
(152,644
)
 
220,359

Contract assets

 
94,567

 
94,567

Prepaid expenses and other current assets
84,215

 
19,452

 
103,667

Total current assets
1,422,179

 
(38,625
)
 
1,383,554

Property and equipment, net
180,412

 

 
180,412

Goodwill
4,292,571

 

 
4,292,571

Intangible assets, net
1,286,050

 

 
1,286,050

Deferred income tax assets
20,159

 
5,857

 
26,016

Other long-term assets
84,496

 
12,601

 
97,097

Total assets
$
7,285,867

 
$
(20,167
)
 
$
7,265,700

 
 
 
 
 
 
LIABILITIES AND SHAREHOLDERS' EQUITY
 

 
 
 
 
Current liabilities:
 
 
 
 
 
Accounts payable
$
58,575

 
$

 
$
58,575

Accrued liabilities
500,303

 
49,611

 
549,914

Contract liabilities
559,270

 
34,075

 
593,345

Current portion of capital lease obligations
16,414

 

 
16,414

Current portion of long-term debt
25,000

 

 
25,000

Total current liabilities
1,159,562

 
83,686

 
1,243,248

Capital lease obligations, non-current
20,376

 

 
20,376

Long-term debt, non-current
2,945,934

 

 
2,945,934

Deferred income tax liabilities
37,807

 
(8,355
)
 
29,452

Other long-term liabilities
99,609

 
3,317

 
102,926

Total liabilities
4,263,288

 
78,648

 
4,341,936

Shareholders' equity:
 
 
 
 
 
Preferred stock

 

 

Common stock
1,044

 

 
1,044

Additional paid-in capital
3,414,389

 

 
3,414,389

Accumulated other comprehensive loss, net of tax
(22,385
)
 

 
(22,385
)
Accumulated deficit
(370,469
)
 
(98,815
)
 
(469,284
)
Total shareholders' equity
3,022,579

 
(98,815
)
 
2,923,764

Total liabilities and shareholders' equity
$
7,285,867

 
$
(20,167
)
 
$
7,265,700


27






The following table compares the reported unaudited condensed consolidated statement of operations for the three and nine months ended September 30, 2018 to the amounts as if the previous revenue recognition guidance remained in effect for the three and nine months ended September 30, 2018 (in thousands, except per share amounts):
 
Three Months Ended September 30, 2018
 
Nine Months Ended September 30, 2018
 
ASC 606
As Reported
 
ASC 605
As Adjusted
 
ASC 606
As Reported
 
ASC 605
As Adjusted
Service revenue
$
1,114,918

 
$
787,502

 
$
3,244,644

 
$
2,344,021

Reimbursable out-of-pocket expenses

 
332,853

 

 
942,396

Total revenue
1,114,918

 
1,120,355

 
3,244,644

 
3,286,417

Direct costs (exclusive of depreciation and amortization)
539,570

 
539,239

 
1,619,620

 
1,624,249

Reimbursable out-of-pocket expenses
332,644

 
332,853

 
940,882

 
942,396

Selling, general, and administrative
96,943

 
97,737

 
296,420

 
298,266

Restructuring and other costs
19,349

 
19,349

 
41,647

 
41,647

Transaction and integration-related expenses
18,561

 
18,561

 
61,804

 
61,804

Depreciation
17,639

 
17,639

 
53,224

 
53,224

Amortization
50,395

 
50,395

 
150,333

 
150,333

Total operating expenses
1,075,101

 
1,075,773

 
3,163,930

 
3,171,919

Income (loss) from operations
39,817

 
44,582

 
80,714

 
114,498

Other expense, net:
 
 
 
 
 

 
 
Interest income
1,004

 
1,004

 
3,498

 
3,498

Interest expense
(33,097
)
 
(33,097
)
 
(97,727
)
 
(97,727
)
Loss on extinguishment of debt
(1,789
)
 
(1,789
)
 
(3,914
)
 
(3,914
)
Other (expense) income, net
(4,346
)
 
(4,346
)
 
15,101

 
15,101

Total other expense, net
(38,228
)
 
(38,228
)
 
(83,042
)
 
(83,042
)
Income (loss) before provision for income taxes
1,589

 
6,354

 
(2,328
)
 
31,456

Income tax expense
(11,983
)
 
(8,129
)
 
(19,058
)
 
(21,505
)
Net (loss) income
(10,394
)
 
(1,775
)
 
(21,386
)
 
9,951

Earnings (loss) per share attributable to common shareholders:
 
 
 
 
 
 
 
Basic
$
(0.10
)
 
$
(0.02
)
 
$
(0.21
)
 
$
0.10

Diluted
$
(0.10
)
 
$
(0.02
)
 
$
(0.21
)
 
$
0.10

Weighted average common shares outstanding:
 
 
 
 
 
 
 
Basic
103,012

 
103,012

 
103,453

 
103,453

Diluted
103,012

 
103,012

 
103,453

 
104,661


28






The following is a summary of the significant changes in the Company’s unaudited condensed consolidated statement of operations as a result of adopting ASC 606 on January 1, 2018, compared to the amounts as if the Company had continued to report its results under ASC 605:
ASC 606 delayed the recognition of revenue principally related to Full Service customer clinical trials in the Company’s Clinical Solutions segment for the three and nine months ended September 30, 2018 as revenue was previously recognized when contractual items (i.e. “units”) were delivered or on a proportional performance basis, generally using output measures of progress specific to the services provided, such as site or investigator recruitment, patient enrollment and data management. These measures excluded reimbursed investigator payments, other pass-through costs, and out-of-pocket expenses, which were recognized as incurred and presented separately as a component of total revenue in the unaudited condensed consolidated statement of operations. Pursuant to the adoption of ASC 606, the majority of revenue recognized related to Full Service customer clinical trials is accounted for using project costs as an input measure of progress, and includes reimbursable pass-through costs and out-of-pocket expenses.
ASC 606 delayed the recognition of revenue in the Company’s Commercial Solutions segment for the nine months ended September 30, 2018 as certain costs to recruit and train the contract field promotion teams, and revenue for the related reimbursements, are deferred and amortized over the contract term under ASC 606. These amounts were previously recognized as each separate service was delivered to the customer. These delays were partially offset by the acceleration of revenue recognition on certain incentive fee programs that were previously recognized upon customer approval. For the three months ended September 30, 2018 the recognition of revenue under ASC 606 and ASC 605 was comparatively similar.

29






The following table compares the reported unaudited condensed consolidated balance sheet as of September 30, 2018 to the amounts as if the previous revenue recognition guidance remained in effect as of September 30, 2018 (in thousands):
 
September 30, 2018
 
ASC 606
As Reported
 
ASC 605
As Adjusted
ASSETS
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
132,402

 
$
132,402

Restricted cash
2,202

 
2,202

Accounts receivable billed, net
656,682

 
656,682

Accounts receivable unbilled
347,894

 
496,003

Contract assets
136,824

 

Prepaid expenses and other current assets
80,418

 
62,638

Total current assets
1,356,422

 
1,349,927

Property and equipment, net
175,128

 
175,128

Goodwill
4,352,825

 
4,352,825

Intangible assets, net
1,189,665

 
1,189,665

Deferred income tax assets
32,702

 
27,047

Other long-term assets
102,951

 
93,085

Total assets
$
7,209,693

 
$
7,187,677

 
 
 
 
LIABILITIES AND SHAREHOLDERS' EQUITY
 
 
 
Current liabilities:
 
 
 
Accounts payable
$
82,204

 
$
82,204

Accrued liabilities
527,225

 
479,118

Contract liabilities
709,027

 
600,871

Current portion of capital lease obligations
16,603

 
16,603

Current portion of long-term debt
62,050

 
62,050

Total current liabilities
1,397,109

 
1,240,846

Capital lease obligations, non-current
21,568

 
21,568

Long-term debt, non-current
2,775,631

 
2,775,631

Deferred income tax liabilities
58,612

 
67,914

Other long-term liabilities
123,745

 
120,387

Total liabilities
4,376,665

 
4,226,346

Shareholders' equity:
 
 
 
Preferred stock

 

Common stock
1,032

 
1,032

Additional paid-in capital
3,390,734

 
3,390,734

Accumulated other comprehensive loss, net of tax
(53,735
)
 
(55,585
)
Accumulated deficit
(505,003
)
 
(374,850
)
Total shareholders' equity
2,833,028

 
2,961,331

Total liabilities and shareholders' equity
$
7,209,693

 
$
7,187,677



30






The following is a summary of the significant changes in the Company’s unaudited condensed consolidated balance sheets as a result of adopting ASC 606 on January 1, 2018, compared to the amounts as if the Company had continued to report its results under ASC 605:
The reported assets were greater than the total assets that would have been reported had the prior revenue recognition guidance remained in effect. This was largely due to the deferral of certain recruiting and training costs in Commercial Solutions contracts and capitalized sales commissions. The reported liabilities were greater than the total liabilities that would have been reported had the prior revenue recognition guidance remained in effect. This was largely due to advances and deferred revenue in excess of contract assets that are required to be presented net on a contract-by-contract basis.
The adoption of ASC 606 primarily resulted in a revenue recognition delay as of January 1, 2018, which resulted in an increase of the Company’s deferred tax asset position. As the Company records full reserves for its net federal deferred tax assets in the United States, a portion of the impact was offset by a corresponding increase to the valuation allowance against the deferred tax asset position.
The adoption of ASC 606 had no net impact on the Company’s cash flows from operations.
13 . Segment Information
During the third quarter of 2017, the Company realigned its operating segments as a result of the Merger to reflect the current structure under which performance is evaluated, strategic decisions are made and resources are allocated. As a result of this realignment, effective August 1, 2017, the Company began evaluating its financial performance based on two reportable segments: Clinical Solutions and Commercial Solutions. Historical segment reporting has been revised to reflect these changes to the Company’s segment structure.

Each reportable business segment comprises multiple similar service offerings that, when combined, create a fully integrated biopharmaceutical outsourcing solutions organization . Clinical Solutions offers a variety of services spanning Phase I to Phase IV of clinical development , including full-service global studies, as well as individual service offerings such as clinical monitoring, investigator recruitment, patient recruitment, data management, and study startup to assist customers with their drug development process. Commercial Solutions provides commercialization services to the pharmaceutical, biotechnology, and healthcare industries, which include outsourced selling solutions, communication solutions (public relations and advertising), and consulting related services.

The Company’s Chief Operating Decision Maker (“CODM”) reviews segment performance and allocates resources based upon segment revenue and income from operations. Beginning in 2018, as a result of the Company’s adoption of ASC 606, revenue and costs for reimbursed out-of-pocket expenses are allocated to the Company’s segments. Prior to 2018, revenue and costs for reimbursed out-of-pocket expenses were not allocated to the Company’s segments. Inter-segment revenue is eliminated from the segment reporting presented to the CODM and is not included in the segment revenue presented in the table below. Certain costs are not allocated to the Company’s reportable segments and are reported as general corporate expenses. These costs primarily consist of share-based compensation and general operating expenses associated with the Company’s senior leadership, finance, Board of Directors, investor relations, and internal audit functions. The Company does not allocate depreciation, amortization, restructuring, or transaction and integration-related costs to its segments. Additionally, the CODM reviews the Company’s assets on a consolidated basis and the Company does not allocate assets to its reportable segments as they are not included in the review performed by the CODM for purposes of assessing segment performance or allocating resources.


31






Information about reportable segment operating results is as follows (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Revenue:
 
 
 
 
 
 
 
Clinical Solutions service revenue
$
819,203

 
$
432,780

 
$
2,389,955

 
$
937,781

Commercial Solutions service revenue
295,715

 
159,427

 
854,689

 
164,591

Total segment service revenue
1,114,918

 
592,207

 
3,244,644

 
1,102,372

Reimbursable out-of-pocket expenses not allocated to segments

 
230,121

 

 
493,009

Total consolidated revenue
$
1,114,918

 
$
822,328

 
$
3,244,644

 
$
1,595,381

Segment direct costs:
 
 
 
 
 
 
 
Clinical Solutions
$
352,049

 
$
284,872

 
$
1,063,019

 
$
591,383

Commercial Solutions
182,305

 
115,538

 
542,061

 
120,205

Total segment direct costs
$
534,354

 
$
400,410

 
$
1,605,080

 
$
711,588

Reimbursable out-of-pocket expenses:
 
 
 
 
 
 
 
Clinical Solutions
$
281,209

 
$

 
$
794,604

 
$

Commercial Solutions
51,435

 

 
146,278

 

Total segment reimbursable out-of-pocket expenses
$
332,644

 
$

 
$
940,882

 
$

Segment selling, general, and administrative expenses:
 
 
 
 
 
 
 
Clinical Solutions
$
63,707

 
$
59,142

 
$
197,764

 
$
131,208

Commercial Solutions
22,182

 
18,113

 
63,368

 
18,113

Total segment selling, general, and administrative expenses
$
85,889

 
$
77,255

 
$
261,132

 
$
149,321

Segment operating income:
 
 
 
 
 
 
 
Clinical Solutions
$
122,238

 
$
88,766

 
$
334,568

 
$
215,190

Commercial Solutions
39,793

 
25,776

 
102,982

 
26,273

Total segment operating income
$
162,031

 
$
114,542

 
$
437,550

 
$
241,463

Operating expenses not allocated to segments:
 
 
 
 
 
 
 
Reimbursable out-of-pocket expenses not allocated to segments
$

 
$
230,121

 
$

 
$
493,009

Corporate selling, general, and administrative expenses not allocated to segments
6,479

 
9,435

 
23,874

 
18,453

Share-based compensation included in direct costs not allocated to segments
5,216

 
5,388

 
14,540

 
11,055

Share-based compensation included in selling, general, and administrative expenses not allocated to segments
4,575

 
2,165

 
11,414

 
8,546

Restructuring and other costs
19,349

 
6,670

 
41,647

 
12,626

Transaction and integration-related expenses
18,561

 
84,340

 
61,804

 
108,081

Asset impairment charges

 
30,000

 

 
30,000

Depreciation and amortization
68,034

 
65,432

 
203,557

 
96,588

Total consolidated income (loss) from operations
$
39,817

 
$
(88,888
)
 
$
80,714

 
$
(43,886
)

32






14 . Operations by Geographic Location
The Company conducts its global operations through wholly-owned subsidiaries and representative sales offices. Prior to the Merger, service revenue was attributed to geographical locations based upon the location to which the Company invoiced the end customer. Following the Merger, the Company began to attribute service revenues to geographical locations based upon the location of where the work is performed to reflect its expanded geographic presence and increased scale of operations. All prior periods have been recast to reflect the effect of this change.
The following table summarizes information about revenue by geographic area (in thousands and with all intercompany transactions eliminated):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Revenue:
 
 
 
 
 
 
 
North America (a)
$
761,414

 
$
386,466

 
$
2,219,725

 
$
676,759

Europe, Middle East, and Africa
232,916

 
135,347

 
693,874

 
295,452

Asia-Pacific
97,726

 
56,421

 
269,353

 
98,862

Latin America
22,862

 
13,973

 
61,692

 
31,299

Total service revenue
1,114,918

 
592,207

 
3,244,644

 
1,102,372

Reimbursable-out-of-pocket expenses

 
230,121

 

 
493,009

Total revenue
$
1,114,918

 
$
822,328

 
$
3,244,644

 
$
1,595,381

(a) Service revenue for the North America region includes revenue attributable to the United States of $718.0 million and $370.5 million , or 64.4% and 62.6% of total service revenue, for the three months ended September 30, 2018 and September 30, 2017 , respectively. Service revenue for the North America region includes revenue attributable to the United States of $2,104.8 million and $646.8 million , or 64.9% and 58.7% of total service revenue, for the nine months ended September 30, 2018 and September 30, 2017 , respectively. No other country represented more than 10% of service revenue for any period.
Long-lived assets by geographic area for each period were as follows (in thousands and all intercompany transactions have been eliminated):
 
September 30, 2018
 
December 31, 2017
Property and equipment, net:
 
 
 
North America (a)
$
129,588

 
$
136,101

Europe, Middle East and Africa
28,871

 
25,517

Asia-Pacific
12,862

 
14,700

Latin America
3,807

 
4,094

Total property and equipment, net
$
175,128

 
$
180,412

(a) Long-lived assets for the North America region include property and equipment, net attributable to the United States of $123.5 million and $128.5 million as of September 30, 2018 and December 31, 2017 , respectively.
15 . Concentration of Credit Risk
The Company maintains cash depository accounts with several financial institutions worldwide and is exposed to credit risk related to the potential inability to access liquidity in financial institutions where its cash and cash equivalents are concentrated. The Company has not historically incurred any losses with respect to these balances and believes that they bear minimal credit risk.
As of September 30, 2018 , the amount of cash and cash equivalents held outside the United States by the Company’s foreign subsidiaries was $77.5 million , or approximately 59% of the total consolidated cash and cash equivalents balance. As of December 31, 2017 , the amount of cash and cash equivalents

33






held outside the United States by the Company’s foreign subsidiaries was $192.0 million , or approximately 60% of the total consolidated cash and cash equivalents balance.
During the three and nine months ended September 30, 2018 , one customer accounted for approximately 12% and 11% , respectively, of the Company’s service revenue (including reimbursable out-of-pocket expenses as a result of the adoption of ASC 606 described in “Note 12 - Revenue from Contracts with Customers ”). During the  three months ended   September 30, 2017 , one customer accounted for  10%  of the Company’s service revenue.  No single customer accounted for greater than 10% of the Company’s service revenue for the nine months ended September 30, 2017 .
As of September 30, 2018 and December 31, 2017 , one customer accounted for approximately 13% of the Company’s billed accounts receivable, unbilled accounts receivable, and contract assets balances.
16 . Related-Party Transactions
For the three and nine months ended September 30, 2018 , the Company incurred reimbursable out-of-pocket expenses of $1.6 million and $2.8 million , respectively, for professional services obtained from two providers, one whose significant shareholder was also a significant shareholder of the Company and the other whose member of the Board of Directors was also a member of the Company’s Board of Directors. Additionally, at September 30, 2018 the Company had liabilities of $1.0 million included in the “Accounts Payable” and “Accrued Liabilities” line items on the unaudited condensed consolidated balance sheets associated with these related parties. For the  three and nine months ended   September 30, 2017 , the Company incurred reimbursable out-of-pocket expenses of $0.2 million for professional services obtained from a provider whose significant shareholder was also a significant shareholder of the Company.
No material related-party revenue was recorded for the  three and nine months ended   September 30, 2018 or 2017
17 . Commitments and Contingencies
Self-Insurance Reserves
The Company is self-insured for certain losses relating to health insurance claims for the majority of its employees located within the United States. Additionally, the Company maintains certain self-insurance retention limits related to automobile and workers’ compensation insurance. As of September 30, 2018 and December 31, 2017 , the total accrual for self-insurance reserves was $17.2 million and $16.6 million , respectively.
Assumed Contingent Tax-Sharing Obligations
As a result of the Merger, the Company assumed contingent tax-sharing obligations arising from inVentiv’s 2016 merger with Double Eagle Parent, Inc. As of September 30, 2018 and December 31, 2017 , the estimated fair value of the assumed contingent tax-sharing obligations was $54.1 million and $50.5 million , respectively. For additional information, refer to “Note 3 - Business Combinations .”
Contingent Earn-out Liability
In connection with the Kinapse acquisition, the Company recorded a contingent earn out liability to be paid based on Kinapse meeting revenue targets as of March 31, 2021. The fair value of the earn out liability is remeasured at the end of each reporting period, with changes in the estimated fair value reflected in earnings until the liability is settled. The estimated fair value of the contingent earn out liability was $4.5 million as of September 30, 2018 and is included in the “Other long-term liabilities” line item of the accompanying unaudited condensed consolidated balance sheets. For additional information, refer to “Note 3 - Business Combinations .”

34






Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
Forward Looking Statements
You should read the following discussion and analysis of our financial condition and results of operations in conjunction with our unaudited condensed consolidated financial statements and the notes thereto included elsewhere in this Quarterly Report on Form 10-Q and with our audited consolidated financial statements and the notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2017 .
In addition to historical condensed consolidated financial information, the following discussion contains forward-looking statements that reflect, among other things, our current expectations and anticipated results of operations, all of which are subject to known and unknown risks, uncertainties, and other factors that may cause our actual results, performance or achievements, market trends, or industry results to differ materially from those expressed or implied by such forward-looking statements. Therefore, any statements contained herein that are not statements of historical fact may be forward-looking statements and should be evaluated as such. Without limiting the foregoing, the words “anticipates,” “believes,” “estimates,” “expects,” “intends,” “may,” “plans,” “projects,” “should,” “targets,” “will” and the negative thereof, and similar words and expressions are intended to identify forward-looking statements. Unless legally required, we assume no obligation to update any such forward-looking information to reflect actual results or changes in the factors affecting such forward-looking information.
We caution you that any such forward-looking statements are further qualified by important factors that could cause our actual operating results to differ materially from those in the forward-looking statements, including without limitation, regional, national, or global political, economic, business, competitive, market, and regulatory conditions and the following: the need to hire, develop, and retain key personnel; the impact of unfavorable economic conditions, including the uncertain international economic environment, changes in exchange rates, and effective income tax rate fluctuations; the impact of potentially underpricing our contracts, overrunning our cost estimates, or failing to receive approval for or experiencing delays with documentation of change orders; any adverse effects from customer or therapeutic area concentration; our potential failure to generate a large number of new business awards and the risk of delay, termination, reduction in scope, or failure to go to contract of our business awards; our potential failure to convert backlog to revenue; the cyber-security and other risks associated with our information systems infrastructure; risks associated with the integration of our business with the business of inVentiv and our operation of the combined business following the closing of the Merger; the risks associated with doing business internationally; the impact of adoption of the new accounting standard of recognizing revenue from customers; impact of the Tax Act ; our potential failure to successfully increase our market share, grow our business, and execute our growth strategies; our failure to perform our services in accordance with contractual requirements, regulatory standards, and ethical considerations; the risk of litigation and personal injury claims; the risks associated with potential future acquisitions or investments in our customers’ businesses or drugs; the impact of changes in government regulations and healthcare reform; and the cost of and our ability to service our substantial indebtedness. For a further discussion of the risks relating to our business, refer to “Risk Factors” in Part I, Item 1A of our Annual Report on Form 10-K for the fiscal year ended December 31, 2017 .
Overview of Our Business and Services
Syneos Health, Inc. (the “Company,” “we,” “us,” and “our”) is a leading global biopharmaceutical services organization comprised of an end-to-end clinical contract research organization (“CRO”) and contract commercial organization (“CCO”). We offer both standalone and integrated biopharmaceutical development and commercialization services ranging from Phase I to Phase IV clinical trial services to services associated with the commercialization of biopharmaceutical products. Our customers include small, mid-sized, and large companies in the pharmaceutical, biotechnology, and medical device industries, and our revenue is derived through a broad suite of services designed to enhance our customers’ ability to successfully develop, launch, and market their products. We consistently and

35



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predictably deliver our services in a complex environment and offer a proprietary, operational approach to the delivery of our projects through our Trusted Process ® methodology.
On August 1, 2017, we completed a merger (the “Merger”) with Double Eagle Parent, Inc. (“inVentiv”), the parent company of inVentiv Health, Inc. under the terms of the merger agreement, dated May 10, 2017 (the “Merger Agreement”). Upon closing, inVentiv was merged with and into us, and the separate corporate existence of inVentiv ceased. Refer to further discussion in “Note 3 - Business Combinations ” to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q for additional details on the Merger.
Following the Merger, we realigned our operating segments to reflect the current structure under which we evaluate our performance, make strategic decisions, and allocate resources. As a result of this realignment, effective August 1, 2017, we began managing our business through two reportable segments: Clinical Solutions and Commercial Solutions.
Our Clinical Solutions segment offers a variety of services spanning Phase I to Phase IV of clinical development , including full-service global studies, as well as individual service offerings such as clinical monitoring, investigator recruitment, patient recruitment, data management, and study startup to assist customers with their drug development process. Our Commercial Solutions segment provides the pharmaceutical, biotechnology, and healthcare industries with commercialization services including outsourced selling solutions, communication solutions (public relations and advertising), and consulting services. Our management reviews segment performance and allocates resources based upon segment revenue and segment operating income. Historical segment reporting has been revised to reflect these changes to our segment structure. Prior to the Merger, our Commercial Solutions segment consisted solely of a consulting offering. Refer to further discussion in “Note 13 - Segment Information ” to our unaudited condensed consolidated financial statement s in Part I, Item 1 of this Quarterly Report on Form 10-Q.
For financial information regarding revenue and long-lived assets by geographic area, refer to “Note 14 - Operations by Geographic Location ” to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q.
New Business Awards and Backlog
We add new business awards to backlog when we enter into a contract or when we receive a written commitment from the customer selecting us as a service provider, provided that:
the customer has received appropriate internal funding approval and collection of the award value is probable;
the project or projects are not contingent upon completion of another trial or event;
the project or projects are expected to commence within a certain period of time from the end of the quarter in which the award was granted;
the customer has entered or intends to enter into a comprehensive contract as soon as practicable; and
for awards related to our FSP offering, only a maximum of twelve months of services are included.
In addition, we continually evaluate our backlog to determine if any of the previously awarded work is no longer expected to be performed, regardless of whether we have received formal cancellation notice from the customer. If we determine that any previously awarded work is no longer probable of being performed, we remove the value from our backlog based on the risk of cancellation. We recognize revenue from these awards as services are performed, provided we have entered into a contractual commitment with the customer.

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We currently report new business awards for our Clinical Solutions and Commercial Solutions segments and backlog for our Clinical Solutions segment and the selling solutions service offering within our Commercial Solutions segment. We do not currently report backlog data for the remaining service offerings in the Commercial Solutions segment.
Beginning on January 1, 2018 we adopted the ASC 606 revenue recognition standard and as a result, we no longer present service revenue and revenue associated with reimbursable out-of-pocket expenses separately in the statements of operations as, under ASC 606, they represent a single performance obligation and separate presentation is no longer permitted. However, revenue associated with reimbursable out-of-pocket expenses represents expenses which are passed through and reimbursed by our customers at actual cost. These expenses fluctuate significantly from period to period based on the timing of program initiation or closeout and the mix of program complexity, and therefore anticipated timing associated with this type of revenue is not predictable. As a result, we have not adjusted our backlog or net new business awards information included below to incorporate revenue associated with reimbursable out-of-pocket expenses and have instead presented these metrics as if the previous accounting guidance (ASC 605) had been in effect.
Backlog
Our backlog consists of anticipated future fee revenue from business awards that either have not started but are anticipated to begin in the future (as noted above), or that are in process and have not been completed. Our backlog also reflects any cancellation or adjustment activity related to these contracts. The average duration of our contracts will fluctuate from period to period in the future based on the contracts comprising our backlog at any given time. The majority of our contracts can be terminated by the customer with a 30-day notice.
The following table sets forth backlog as of the following dates under ASC 605 (in millions):
 
Balance at September 30,
 
 
 
 
2018
 
2017
 
Change
Clinical Solutions
$
4,220.6

 
$
3,711.7

 
$
508.9

13.7
%
Commercial Solutions - Selling Solutions (a)
460.3

 

 
460.3

n/m

Total Backlog
$
4,680.9

 
$
3,711.7

 
$
969.2

26.1
%
(a)  Following our Merger with inVentiv and beginning January 1, 2018, we began reporting information related to backlog associated with the selling solutions service offering within our Commercial Solutions segment. This information is not presented for periods prior to 2018.
Included in backlog at September 30, 2018 is approximately $664.2 million that we expect to recognize as service revenue in 2018. We adjust the amount of our backlog each quarter for the effects of fluctuations in foreign currency exchange rates.
We believe that our backlog and net new business awards might not be consistent indicators of future revenue because they have been, and likely will be, affected by a number of factors, including the variable size and duration of projects, many of which are performed over several years, and cancellations and changes to the scope of work during the course of projects. Additionally, projects may be canceled or delayed by the customer or regulatory authorities. We generally do not have a contractual right to the full amount of the awards reflected in our backlog. If a customer cancels an award, we generally have the right to be reimbursed for the costs we have incurred. As we increasingly compete for and enter into large contracts that are more global in nature, we expect that the duration of projects and the period over which related revenue is recognized to lengthen, and therefore expect that the rate at which our backlog and net new business awards convert into revenue is likely to decrease. In addition, our adoption of the new revenue recognition standard in 2018 may result in delays in revenue recognition. For more information about risks related to our backlog refer to Part I, Item 1A "Risk Factors—Risks Related to Our Business—Our backlog might not be indicative of our future revenues, and we might not realize all of the anticipated future revenue reflected in our backlog" in our Annual Report on Form 10-K for the fiscal year ended December 31, 2017 .

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Net new business awards
The following table sets forth new business awards, net of cancellations of prior awards under ASC 605 (in millions):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Clinical Solutions
$
676.0

 
$
578.3

 
$
2,075.6

 
$
1,213.4

Commercial Solutions
244.2

 

 
772.4

 

    Total net new business awards
$
920.2

 
$
578.3

 
$
2,848.0

 
$
1,213.4

Net new business awards for our Clinical Solutions segment were higher during the three and nine months ended September 30, 2018 , primarily due to the Merger. Effective January 1, 2018, we began reporting information related to net new business awards associated with our Commercial Solutions segment. This information is not presented for periods prior to 2018.
New business awards have varied and may continue to vary significantly from quarter to quarter. Fluctuations in our net new business award levels often result from the fact that we may receive a small number of relatively large orders in any given reporting period. Because of these large orders, our backlog and net new business awards in a reporting period may reach levels that are not sustainable in subsequent reporting periods.
Results of Operations
The following table sets forth amounts from our unaudited condensed consolidated financial statements along with the percentage changes (in thousands, except percentages):
 
Three Months Ended 
 September 30,
 
 
 
 
 
2018
 
2017
 
Change
Service revenue
$
1,114,918

 
$
592,207

 
$
522,711

 
88.3
 %
Reimbursable out-of-pocket expenses

 
230,121

 
(230,121
)
 
n/m

Total revenue
1,114,918

 
822,328

 
292,590

 
35.6
 %
Costs and operating expenses:
 
 
 
 
 
 
 
Direct costs (exclusive of depreciation and amortization)
539,570

 
405,798

 
133,772

 
33.0
 %
Reimbursable out-of-pocket expenses
332,644

 
230,121

 
102,523

 
44.6
 %
Selling, general, and administrative
96,943

 
88,855

 
8,088

 
9.1
 %
Restructuring and other costs
19,349

 
6,670

 
12,679

 
190.1
 %
Transaction and integration-related expenses
18,561

 
84,340

 
(65,779
)
 
(78.0
)%
Asset impairment charges

 
30,000

 
(30,000
)
 
n/m

Depreciation and amortization
68,034

 
65,432

 
2,602

 
4.0
 %
Total operating expenses
1,075,101

 
911,216

 
163,885

 
18.0
 %
Income (loss) from operations
39,817

 
(88,888
)
 
128,705

 
144.8
 %
Total other expense, net
(38,228
)
 
(32,986
)
 
(5,242
)
 
(15.9
)%
Income (loss) before provision for income taxes
1,589

 
(121,874
)
 
123,463

 
101.3
 %
Income tax expense
(11,983
)
 
(26,124
)
 
14,141

 
54.1
 %
Net loss
$
(10,394
)
 
$
(147,998
)
 
$
137,604

 
93.0
 %

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Nine Months Ended 
 September 30,
 
 
 
 
 
2018
 
2017
 
Change
Service revenue
$
3,244,644

 
$
1,102,372

 
$
2,142,272

 
194.3
 %
Reimbursable out-of-pocket expenses

 
493,009

 
(493,009
)
 
n/m

Total revenue
3,244,644

 
1,595,381

 
1,649,263

 
103.4
 %
Costs and operating expenses:
 

 
 

 
 

 
 

Direct costs (exclusive of depreciation and amortization)
1,619,620

 
722,643

 
896,977

 
124.1
 %
Reimbursable out-of-pocket expenses
940,882

 
493,009

 
447,873

 
90.8
 %
Selling, general, and administrative
296,420

 
176,320

 
120,100

 
68.1
 %
Restructuring and other costs
41,647

 
12,626

 
29,021

 
229.9
 %
Transaction and integration-related expenses
61,804

 
108,081

 
(46,277
)
 
(42.8
)%
Asset impairment charges

 
30,000

 
(30,000
)
 
n/m

Depreciation and amortization
203,557

 
96,588

 
106,969

 
110.7
 %
Total operating expenses
3,163,930

 
1,639,267

 
1,524,663

 
93.0
 %
Income (loss) from operations
80,714

 
(43,886
)
 
124,600

 
283.9
 %
Total other expense, net
(83,042
)
 
(49,319
)
 
(33,723
)
 
(68.4
)%
Loss before provision for income taxes
(2,328
)
 
(93,205
)
 
90,877

 
97.5
 %
Income tax expense
(19,058
)
 
(30,217
)
 
11,159

 
36.9
 %
Net loss
$
(21,386
)
 
$
(123,422
)
 
$
102,036

 
82.7
 %
Service Revenue
For the three months ended September 30, 2018 , our service revenue increased by $522.7 million , or 88.3% , to $1.11 billion from $592.2 million for the three months ended September 30, 2017 . For the nine months ended September 30, 2018 , our service revenue increased by $2.14 billion , or 194.3% , to $3.24 billion from $1.10 billion for the nine months ended September 30, 2017 .
As a result of adopting the new revenue recognition standard on January 1, 2018, we no longer present service revenue and revenue associated with reimbursable out-of-pocket expenses separately in the statements of operations as, under the new revenue recognition standard, they represent a single performance obligation and separate presentation is no longer permitted. The inclusion of revenue associated with reimbursable out-of-pocket expenses in service revenue in 2018 contributed to approximately 56.2% and 85.3% , respectively, of the increases to service revenue for the three and nine months ended September 30, 2018 . Service revenue for the three and nine months ended September 30, 2018 was comprised of fee revenue of $782.3 million and $2.30 billion , and revenue associated with reimbursable out-of-pocket expenses of $332.6 million and $940.9 million , respectively. Comparatively, service revenue, which represents fee revenue only, for the three and nine months ended September 30, 2017 was $592.2 million and $1.10 billion , respectively. Revenue associated with reimbursable out-of-pocket expenses for the three and nine months ended September 30, 2017 was $230.1 million and $493.0 million , respectively.
For the three and nine months ended September 30, 2018 , our service revenue increased compared to the same period in the prior year primarily as a result of: (i) the inclusion of revenue associated with reimbursable out-of-pocket expenses as a component of service revenue in 2018, as discussed above; and (ii) the Merger with inVentiv in August 2017. These increases were partially offset by: (i) unfavorable impacts from adoption of ASC 606 of $5.2 million and $40.3 million , respectively; (ii) a less favorable revenue mix in our Clinical Solutions segment during the three months ended September 30, 2018 ; and (iii) reductions in revenue of approximately $2.9 million and $10.5 million , respectively, due to the fair value adjustments required by purchase accounting.

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During the three and nine months ended September 30, 2018 , one customer accounted for approximately 12% and 11% , respectively, of our service revenue (which includes revenue associated with reimbursable out-of-pocket expenses as a result of our adoption of ASC 606). During the  three months ended   September 30, 2017 , one customer accounted for  10%  of our service revenue.  No single customer accounted for greater than 10% of our service revenue for the nine months ended September 30, 2017 . Service revenue from our top five customers accounted for approximately 25% of total consolidated service revenue for both the three months ended September 30, 2018 and 2017 , respectively. Service revenue from our top five customers accounted for approximately 25% and 23% of total consolidated service revenue for the nine months ended September 30, 2018 and 2017 , respectively.
Service revenue for each of our segments was as follows (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
 
 
2018
 
% of total
 
2017
 
% of total
 
Change
Clinical Solutions
$
819,203

 
73.5
%
 
$
432,780

 
73.1
%
 
$
386,423

 
89.3
%
Commercial Solutions
295,715

 
26.5
%
 
159,427

 
26.9
%
 
136,288

 
85.5
%
Total service revenue
$
1,114,918

 
 
 
$
592,207

 
 
 
$
522,711

 
88.3
%
 
Nine Months Ended September 30,
 
 
 
 
 
2018
 
% of total
 
2017
 
% of total
 
Change
Clinical Solutions
$
2,389,955

 
73.7
%
 
$
937,781

 
85.1
%
 
$
1,452,174

 
154.9
%
Commercial Solutions
854,689

 
26.3
%
 
164,591

 
14.9
%
 
690,098

 
419.3
%
Total service revenue
$
3,244,644

 
 
 
$
1,102,372

 
 
 
$
2,142,272

 
194.3
%
Clinical Solutions
Our Clinical Solutions segment is a leading global CRO that is therapeutically-focused and offers a variety of clinical development services spanning Phase I to Phase IV, including full-service global studies, as well as unbundled service offerings such as clinical monitoring, investigator recruitment, patient recruitment, data management, and study startup to assist customers with their drug development process. For the three and nine months ended September 30, 2018 , our Clinical Solutions segment generated service revenue of $819.2 million and $2.39 billion , representing approximately 73.5% and 73.7% , respectively, of our total service revenue in the period. For the three and nine months ended September 30, 2017 , our Clinical Solutions segment generated service revenue of $432.8 million and $937.8 million , representing approximately 73.1% and 85.1% , respectively, of our total service revenue in the period.
For the three and nine months ended September 30, 2018 , our service revenue attributable to the Clinical Solutions segment increased compared to the same period in the prior year primarily due to: (i) the Merger with inVentiv in August 2017; and (ii) the inclusion of revenue associated with reimbursable out-of-pocket expenses as a component of service revenue in 2018 according to the requirements of the new revenue recognition standard as discussed above. This increase was partially offset by a less favorable revenue mix during the three months ended September 30, 2018 .

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Commercial Solutions

Our Commercial Solutions segment is a leading provider of a full suite of complementary commercialization services, including outsourced field selling solutions, medication adherence, communications (public relations and advertising), and consulting services. For the three and nine months ended September 30, 2018 , our Commercial Solutions segment generated service revenue of $295.7 million and $854.7 million , representing approximately 26.5% and 26.3% , respectively, of total service revenue for the period. For the three and nine months ended September 30, 2017 , our Commercial Solutions segment generated service revenue of $159.4 million and $164.6 million , representing approximately 26.9% and 14.9% , respectively, of total service revenue for the period.
For the three months ended September 30, 2018 , our Commercial Solutions service revenue increased compared to the same periods in the prior year due to the Merger with inVentiv in August 2017. Additionally during the third quarter of 2018, our service revenue associated with this segment increased on a comparative basis to amounts reported by inVentiv in periods prior to the merger.
For the nine months ended September 30, 2018 , our Commercial Solutions service revenue increased on a comparative basis due to the Merger. However, service revenue associated with this segment declined on a year-over-year basis compared to the amounts reported by inVentiv in periods prior to the Merger, primarily as a result of project cancellations and customer downsizing within our selling solutions and communications service offerings, along with lower new business awards in 2017 that reduced 2018 revenue.
Direct Costs and Reimbursable Out-of-Pocket Expenses
Direct costs and reimbursable out-of-pocket expenses were comprised of the following (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs (exclusive of depreciation and amortization)
$
539,570

 
$
405,798

 
$
133,772

 
33.0
%
Reimbursable out-of-pocket expenses
332,644

 
230,121

 
102,523

 
44.6
%
Total direct costs and reimbursable out-of-pocket expenses
$
872,214

 
$
635,919

 
$
236,295

 
37.2
%
Percentage of service revenue
78.2
%
 
68.5
%
 
 
 
 
Gross margin percentage
21.8
%
 
31.5
%
 
 
 
 
 
Nine Months Ended September 30,
 
 
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs (exclusive of depreciation and amortization)
$
1,619,620

 
$
722,643

 
$
896,977

 
124.1
%
Reimbursable out-of-pocket expenses
940,882

 
493,009

 
447,873

 
90.8
%
Total direct costs and reimbursable out-of-pocket expenses
$
2,560,502

 
$
1,215,652

 
$
1,344,850

 
110.6
%
Percentage of service revenue
78.9
%
 
65.6
%
 
 
 
 
Gross margin percentage
21.1
%
 
34.4
%
 
 
 
 
(a) As a result of the adoption of the new revenue recognition standard on January 1, 2018, we allocate reimbursable out-of-pocket expenses to our gross margin and the related revenue percentage.
(b) Prior to the adoption of the new revenue standard on January 1, 2018, reimbursable out-of-pocket expenses were not included in our calculation of gross margin and the related revenue percentage.

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Direct Costs
Direct costs consist principally of compensation and benefits expenses associated with our employees and other employee-related costs. While we can manage the majority of these costs relative to the amount of contracted services we have during any given period, direct costs as a percentage of service revenue may vary from period to period. Such fluctuations are due to a variety of factors, including, among others: (i) the level of staff utilization created by our ability to effectively manage our workforce, (ii) adjustments to the timing of work on specific customer contracts, (iii) the experience mix of personnel assigned to projects, and (iv) the service mix and pricing of our contracts. In addition, as global projects wind down or as delays and cancellations occur, staffing levels in certain countries or functional areas can become misaligned with the current business volume.
For the three months ended September 30, 2018 , our direct costs increased by $133.8 million , or 33.0% , to $539.6 million from $405.8 million for the three months ended September 30, 2017 . For the nine months ended September 30, 2018 , our direct costs increased by $897.0 million , or 124.1% , to $1.62 billion from $722.6 million for the nine months ended September 30, 2017 . These increases were primarily driven by the Merger with inVentiv which increased our worldwide employee base by approximately 15,000 employees in August 2017, resulting in an overall increase in direct costs compared to the prior year, primarily related to salaries, benefits, and incentive compensation expense.
The following is a summary of the year-over-year fluctuation in components of direct costs (in thousands):
 
Three Months Ended September 30, 2018 to 2017
 
Nine Months Ended September 30, 2018 to 2017
Change in:
 
 
 

Salaries, benefits, and incentive compensation
$
107,206

 
$
765,507

Facilities and IT related costs
25,650

 
75,372

Other
916

 
56,098

Total
$
133,772

 
$
896,977

Reimbursable Out-of-Pocket Expenses
Reimbursable out-of-pocket expenses represent expenses typically not associated with our services which are passed through and reimbursed by our customers at actual cost. Such expenses are incurred within both our clinical and commercial businesses and are generally comprised of: (i) physician and investigator fees, project management, data management and other site-facing study costs; (ii) travel-related expenses; (iii) certain compensation and bonuses of sales representatives and other project team personnel; and (iv) various vendor and third-party fees related to meetings, transportation, sales, marketing, communication, training, storage and other miscellaneous project expenses. These expenses fluctuate significantly from period to period based on the timing of program initiation or closeout and the mix of program complexity, and do not necessarily change in direct correlation to fee revenue.
For the three months ended September 30, 2018 , reimbursable out-of-pocket expenses increased by $102.5 million , or 44.6% , as compared to the three months ended September 30, 2017 . For the nine months ended September 30, 2018 , reimbursable out-of-pocket expenses increased by $447.9 million , or 90.8% , as compared to the nine months ended September 30, 2017 . These increases were primarily due to the Merger with inVentiv, which resulted in the increase in the number of studies in which these expenses are incurred.

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Clinical Solutions
Direct costs and reimbursable out-of-pocket expenses for our Clinical Solutions segment, excluding share-based compensation expense, were as follows (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs
$
352,049

 
$
284,872

 
$
67,177

 
23.6
%
Reimbursable out-of-pocket expenses
281,209

 

 
281,209

 
n/m

Total segment direct costs and reimbursable out-of-pocket expenses
$
633,258

 
$
284,872

 
$
348,386

 
122.3
%
Percentage of segment service revenue
77.3
%
 
65.8
%
 
 
 
 
Segment gross margin percentage
22.7
%
 
34.2
%
 
 
 
 
 
Nine Months Ended September 30,
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs
$
1,063,019

 
$
591,383

 
$
471,636

 
79.8
%
Reimbursable out-of-pocket expenses
794,604

 

 
794,604

 
n/m

Total segment direct costs and reimbursable out-of-pocket expenses
$
1,857,623

 
$
591,383

 
$
1,266,240

 
214.1
%
Percentage of segment service revenue
77.7
%
 
63.1
%
 
 
 
 
Segment gross margin percentage
22.3
%
 
36.9
%
 
 
 
 
(a) As a result of the adoption of the new revenue recognition standard on January 1, 2018, we allocate reimbursable out-of-pocket expenses to our operating segments.
(b) Prior to the adoption of the new revenue standard on January 1, 2018, reimbursable out-of-pocket expenses were not allocated to operating segments and therefore are not presented in segment disclosures for periods prior to 2018.
For the three months ended September 30, 2018 and 2017 , direct costs associated with our Clinical Solutions segment were $352.0 million and $284.9 million , or 65.9% and 71.1% , respectively, of segment direct costs. For the three months ended September 30, 2018 , Clinical Solutions direct costs increased by $67.2 million , or 23.6% , as compared to the three months ended September 30, 2017 . For the nine months ended September 30, 2018 and 2017 , direct costs associated with our Clinical Solutions segment were $1.06 billion and $591.4 million , or 66.2% and 83.1% , respectively, of segment direct costs. For the nine months ended September 30, 2018 , Clinical Solutions direct costs increased by $471.6 million , or 79.8% , as compared to the nine months ended September 30, 2017 . The increases in direct costs associated with our Clinical Solutions segment during 2018 compared to the prior year were primarily due to the overall increase in personnel costs as a result of the Merger.
For the three and nine months ended September 30, 2018 , reimbursable out-of-pocket expenses associated with our Clinical Solutions segment were $281.2 million and $794.6 million , representing approximately 84.5% and 84.5% , respectively, of the total reimbursable out-of-pocket expenses for the period.
Clinical Solutions gross margin was 22.7% and 22.3% for the three and nine months ended September 30, 2018 , respectively, compared to 34.2% and 36.9% for the three and nine months ended September 30, 2017 , respectively. Gross margin declined during the three and nine months ended September 30, 2018 compared to the same periods in 2017 primarily due to: (i) inclusion of revenue associated with reimbursable out-of-pocket expenses as a component of service revenue in 2018, which accounted for approximately 11.9% and 11.1% , respectively, of the decrease; (ii) the elimination, due to purchase accounting requirements, of  $2.9 million and $9.7 million , respectively, of revenue from 2018 results that otherwise would have been recognized by inVentiv; and (iii) the mix of customers and service offerings added as a result of the Merger having lower gross margin profile compared to our historical mix of customers and services. Specifically, inVentiv’s Clinical Solutions business has historically had a higher proportion of contracts from the top 20 biopharmaceutical companies and a higher proportion of FSP

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services revenue, both of which typically have a lower margin profile than our historical mix of customers and services.
Commercial Solutions
Direct costs and reimbursable out-of-pocket expenses for our Commercial Solutions segment, excluding share-based compensation expense, were as follows (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs
$
182,305

 
$
115,538

 
$
66,767

 
57.8
%
Reimbursable out-of-pocket expenses
51,435

 

 
51,435

 
n/m

Total segment direct costs and reimbursable out-of-pocket expenses
$
233,740

 
$
115,538

 
$
118,202

 
102.3
%
Percentage of segment service revenue
79.0
%
 
72.5
%
 
 
 
 
Segment gross margin percentage
21.0
%
 
27.5
%
 
 
 
 
 
Nine Months Ended September 30,
 
 
 
2018 (a)
 
2017 (b)
 
Change
Direct costs
$
542,061

 
$
120,205

 
$
421,856

 
350.9
%
Reimbursable out-of-pocket expenses
146,278

 

 
146,278

 
n/m

Total segment direct costs and reimbursable out-of-pocket expenses
$
688,339

 
$
120,205

 
$
568,134

 
472.6
%
Percentage of segment service revenue
80.5
%
 
73.0
%
 
 
 
 
Segment gross margin percentage
19.5
%
 
27.0
%
 
 
 
 
(a) As a result of the adoption of the new revenue recognition standard on January 1, 2018, we allocate reimbursable out-of-pocket expenses to our operating segments.
(b) Prior to the adoption of the new revenue standard on January 1, 2018, reimbursable out-of-pocket expenses were not allocated to operating segments and therefore are not presented in segment disclosures for fiscal periods prior to 2018.
For the three months ended September 30, 2018 and 2017 , direct costs associated with our Commercial Solutions segment were $182.3 million and $115.5 million , representing approximately 34.1% and 28.9% , respectively, of segment direct costs for the period. For the nine months ended September 30, 2018 and 2017 , direct costs associated with our Commercial Solutions segment were $542.1 million and $120.2 million , representing approximately 33.8% and 16.9% , respectively, of segment direct costs for the period. The increases in direct costs associated with our Commercial Solutions segment during 2018 compared to the prior year were primarily due to the 2017 Merger with inVentiv.
For the three and nine months ended September 30, 2018 , reimbursable out-of-pocket expenses associated with our Commercial Solutions segment were $51.4 million and $146.3 million , representing approximately 15.5% and 15.5% , respectively, of total reimbursable out-of-pocket expenses for the period.
The Commercial Solutions gross margin was 21.0% for the three months ended September 30, 2018 , compared to 27.5% for the three months ended September 30, 2017 . The Commercial Solutions gross margin was 19.5% for the nine months ended September 30, 2018 , compared to 27.0% for the nine months ended September 30, 2017 .

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Selling, General, and Administrative Expenses
Selling, general, and administrative expenses were as follows (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
 
 
2018
 
2017
 
Change
Selling, general, and administrative
$
96,943

 
$
88,855

 
$
8,088

 
9.1
%
Percentage of service revenue
8.7
%
 
15.0
%
 
 
 
 
 
Nine Months Ended September 30,
 
 
 
 
 
2018
 
2017
 
Change
Selling, general, and administrative
$
296,420

 
$
176,320

 
$
120,100

 
68.1
%
Percentage of service revenue
9.1
%
 
16.0
%
 
 
 
 
Selling, general, and administrative expenses increased by $8.1 million , or 9.1% , to $96.9 million for the three months ended September 30, 2018 from $88.9 million for the three months ended September 30, 2017 . Selling, general, and administrative expenses increased by $120.1 million , or 68.1% , to $296.4 million for the nine months ended September 30, 2018 from $176.3 million for the nine months ended September 30, 2017 . These increases were primarily due to the Merger with inVentiv in August 2017 and the corresponding increase to our employee base by approximately 15,000 employees, resulting in an overall increase in expenses.
The following is a summary of the year-over-year fluctuation in components of selling, general, and administrative expenses (in thousands):
 
Three Months Ended September 30, 2018 to 2017
 
Nine Months Ended September 30, 2018 to 2017
Change in:
 
 
 

Salaries, benefits, and incentive compensation
$
7,337

 
$
76,562

Professional services fees
5,297

 
30,243

Other expenses
(4,546
)
 
13,295

Total
$
8,088

 
$
120,100

Selling, general, and administrative expenses as a percentage of service revenue were 8.7% for the three months ended September 30, 2018 , compared to 15.0% for the three months ended September 30, 2017 . Selling, general, and administrative expenses as a percentage of service revenue were 9.1% for the nine months ended September 30, 2018 , compared to 16.0% for the nine months ended September 30, 2017 . Of the decrease from the comparable periods in the prior year, approximately 3.7% and 3.8% , respectively, related to the inclusion of reimbursable out-of-pocket expenses as a component of service revenue in 2018 as required by the new revenue recognition standard, while the primary driver was economies of scale resulting from the Merger and our cost containment efforts.

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Restructuring and Other Costs
Restructuring and other costs increased to $19.3 million for the three months ended September 30, 2018 from $6.7 million for the three months ended September 30, 2017 . Restructuring and other costs increased to $41.6 million for the nine months ended September 30, 2018 from $12.6 million for the nine months ended September 30, 2017 . Restructuring and other costs consisted of the following (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Merger-related restructuring and other costs:
 
 
 
 
 
 
 
Employee severance and benefit costs (a)
$
1,936

 
$
3,016

 
$
13,229

 
$
3,016

Facility and lease termination costs (b)
15,794

 

 
20,592

 

Other merger-related costs
33

 

 
548

 

Non-merger related restructuring and other costs:
 
 
 
 
 
 
 
Employee severance and benefit costs
713

 
2,474

 
1,690

 
5,640

Facility and lease termination costs

 
147

 
1,438

 
1,174

Consulting fees (c)
695

 
492

 
3,176

 
1,266

Other costs
178

 
541

 
974

 
1,530

Total restructuring and other costs
$
19,349

 
$
6,670

 
$
41,647

 
$
12,626

(a) In connection with the Merger, we established a restructuring plan to eliminate redundant positions and reduce our facility footprint worldwide. We expect to continue our ongoing evaluations of our workforce and facilities infrastructure needs through 2020 in an effort to optimize our resources worldwide.
(b) We also expect to incur significant costs related to the restructuring of our operations in order to achieve the targeted synergies as a result of the Merger over the next several years. However, the timing and the estimate of the amount of these costs depends on various factors, including, but not limited to, the identification of synergy opportunities and the execution of the integration of our combined operations.
(c) Consulting costs incurred were related to the continued consolidation of our legal entities and restructuring of our contract management process to meet the requirements of the new revenue recognition accounting standard adopted on January 1, 2018.

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Transaction and Integration-Related Expenses
 
Transaction and integration-related expenses decreased to $18.6 million for the three months ended September 30, 2018 from $84.3 million for the three months ended September 30, 2017 . Transaction and integration-related expenses decreased to $61.8 million for the nine months ended September 30, 2018 from $108.1 million for the nine months ended September 30, 2017 . Transaction and integration-related expenses consisted of the following (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Professional fees
$
14,851

 
$
32,519

 
$
40,624

 
$
51,086

Share-based compensation expense

 
31,327

 

 
31,327

Debt modification and related expenses
409

 
5,255

 
1,726

 
5,255

Integration and personnel retention-related costs (a)
2,107

 
12,472

 
15,847

 
17,644

Contingent tax-sharing obligations fair value adjustment
1,194

 

 
3,582

 

Other

 
2,767

 
25

 
2,769

Total transaction and integration-related expenses
$
18,561

 
$
84,340

 
$
61,804

 
$
108,081

(a) In connection with the Merger, we entered into retention agreements with certain key employees. During the nine months ended September 30, 2018 we recognized $8.9 million of expenses related to these retention agreements compared to $10.7 million and $15.8 million , respectively, during the three and nine months ended September 30, 2017 . Payments under these agreements were fully expensed and made to employees in May 2018.
We expect to incur additional integration-related expenses associated with the Merger. The timing and amount of these expenses will depend on the identification of synergy opportunities and the timing and execution of our integration activities.
Asset Impairment Charges
There were no asset impairment charges recorded during the three or nine months ended September 30, 2018 .
In connection with the Merger, we relaunched our operations under a new brand name in January 2018. As a result, we determined that the useful life of the intangible asset related to the INC Research trademark that had a carrying value of $35.0 million was no longer indefinite as of August 1, 2017. Based on this change in circumstances, we tested the asset for impairment as an indefinite-lived intangible asset and recorded a $30.0 million impairment charge during the three months ended September 30, 2017, with the remaining value fully amortized as of December 31, 2017.
Depreciation and Amortization Expense
Total depreciation and amortization expense increased to $68.0 million for the three months ended September 30, 2018 from $65.4 million for the three months ended September 30, 2017 . Total depreciation and amortization expense increased to $203.6 million for the nine months ended September 30, 2018 from $96.6 million for the nine months ended September 30, 2017 . These increases were primarily due to: (i) an increase in amortization expense related to the recognition of intangible assets as part of the Merger; and (ii) an increase in depreciation expense due to assets obtained in the Merger and our continued investment in information technology and facilities to support growth in our operational capabilities and optimization of our infrastructure.

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Other Expense, Net
Other expense, net consisted of the following (in thousands, except percentages):
 
Three Months Ended September 30,
 
 
 
 
 
2018
 
2017
 
Change
Interest income
$
1,004

 
$
501

 
$
503

 
100.4
 %
Interest expense
(33,097
)
 
(27,432
)
 
(5,665
)
 
(20.7
)%
Loss on extinguishment of debt
(1,789
)
 
(102
)
 
(1,687
)
 
n/m

Other (expense) income, net
(4,346
)
 
(5,953
)
 
1,607

 
27.0
 %
Total other expense, net
$
(38,228
)
 
$
(32,986
)
 
$
(5,242
)
 
(15.9
)%
 
Nine Months Ended September 30,
 
 
 
 
 
2018
 
2017
 
Change
Interest income
$
3,498

 
$
765

 
$
2,733

 
357.3
 %
Interest expense
(97,727
)
 
(33,818
)
 
(63,909
)
 
(189.0
)%
Loss on extinguishment of debt
(3,914
)
 
(102
)
 
(3,812
)
 
n/m

Other income (expense), net
15,101

 
(16,164
)
 
31,265

 
193.4
 %
Total other expense, net
$
(83,042
)
 
$
(49,319
)
 
$
(33,723
)
 
(68.4
)%
Total other expense, net increased to net expense of $38.2 million for the three months ended September 30, 2018 from net expense of $33.0 million for the three months ended September 30, 2017 . Total other expense, net increased to net expense of $83.0 million for the nine months ended September 30, 2018 from net expense of $49.3 million for the nine months ended September 30, 2017 . The increases were predominantly related to an increase in interest expense due to higher debt balances as a result of the Merger and an increase in debt extinguishment costs due to our debt prepayment activities during 2018. Partially offsetting these increases were lower foreign exchange losses incurred during the third quarter of 2018 and net foreign exchange gains in the nine months ended September 30, 2018 , compared to the same periods in 2017. Changes related to foreign currency adjustments were a result of exchange rate fluctuations related to monetary asset balances denominated in currencies other than functional currency. We may continue to incur large fluctuations in foreign currency adjustments during future periods as changes in foreign currencies against the U.S. dollar may create gains or losses to the extent that our subsidiaries who use local currency as their functional currency maintain net assets and liabilities balances not denominated in their functional currency.
Income Tax Expense
For the three and nine months ended September 30, 2018 , we recorded income tax expense of $12.0 million and $19.1 million , compared to pre-tax income of $1.6 million and pre-tax loss of $2.3 million , respectively. Variances between effective income tax rate and the statutory income tax rate of 21.0% for the three and nine months ended September 30, 2018 were primarily due to: (i) the recognition of unfavorable discrete adjustments related to foreign currency exchange; (ii) the geographical split of pre-tax income; and (iii) deferred expense related to hanging credits on domestic indefinite-lived intangibles.
For the  three and nine months ended September 30, 2017 , income tax expense was  $26.1 million  and $30.2 million , respectively, compared to pre-tax loss of  $121.9 million  and  $93.2 million , respectively. Variances between our effective income tax rate and the statutory income tax rate of 35.0% for the  three and nine months ended September 30, 2017  were primarily due to: (i) discrete tax expense related to a change in our method of accounting for undistributed foreign earnings; (ii) relative amount of income from operations earned in international jurisdictions with lower statutory income tax rates than the United States; and (iii) discrete tax adjustments related to excess tax benefits on share-based compensation. 


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Net Loss
For the three months ended September 30, 2018 , net loss decreased by $137.6 million to $10.4 million from $148.0 million for the three months ended September 30, 2017 . This decrease in net loss was primarily due to an increase in income from operations due to the Merger with inVentiv in August 2017. Also contributing to the decrease in net loss for three months ended September 30, 2018 were foreign currency exchange gains driven by strengthening of the U.S. dollar in 2018 as compared to 2017. These favorable items were partially offset by an increase in interest expense due to higher debt balances in 2018.
For the nine months ended September 30, 2018 , net loss decreased to $21.4 million compared to $123.4 million for the nine months ended September 30, 2017 . Our net loss for the nine months ended September 30, 2018 was primarily impacted by an increase in other expense, net, due to the increased interest expense as a result of higher debt balances during the nine months ended September 30, 2018 compared to the nine months ended September 30, 2017 , partially offset by foreign currency exchange gains during 2018 compared to losses in 2017.
Liquidity and Capital Resources
Key measures of our liquidity are as follows (in thousands):
 
September 30, 2018
 
December 31, 2017
Balance sheet statistics:
 
 
 
Cash and cash equivalents (a)
$
132,402

 
$
321,262

Working capital (excluding restricted cash)
$
(42,889
)
 
$
261,903

(a) As of September 30, 2018 and December 31, 2017 , cash and cash equivalents held by our foreign subsidiaries were $77.5 million and $192.0 million , respectively. A portion of these cash and cash equivalent balances may be subject to foreign withholding and U.S. taxation, if repatriated.
As of September 30, 2018 , we had $132.4 million of cash and cash equivalents. In addition, we had $485.6 million (net of $14.4 million in outstanding letters of credit) available for borrowing under our $500.0 million revolving credit facility.
We have historically funded our operations and growth, including acquisitions, primarily with our working capital, cash flow from operations and funds available through various borrowing arrangements. Our principal liquidity requirements are to fund our debt service obligations, capital expenditures, expansion of service offerings, possible acquisitions, integration and restructuring costs, geographic expansion, working capital, and other general corporate expenses. Based on the past performance and current expectations, we believe our cash and cash equivalents, cash generated from operations, and funds available under our revolving credit facility and accounts receivable financing agreement will be sufficient to meet our working capital needs, capital expenditures, scheduled debt and interest payments, income tax obligations and other currently anticipated liquidity requirements for at least the next 12 months.
Indebtedness
At September 30, 2018 , we had approximately $2.86 billion of total principal indebtedness (including $38.2 million of capital leases), comprised of $2.23 billion in term loan debt, $403.0 million in Senior Notes, and $183.6 million in borrowings against the accounts receivable financing agreement. In addition, as of September 30, 2018 we had $485.6 million (net of $14.4 million in outstanding letters of credit) of available borrowings for working capital and other purposes under the Revolver and $1.1 million of letters of credit that were not secured by the Revolver. During the nine months ended September 30, 2018 , we made voluntary prepayments of  $299.0 million , which were applied against the regularly-scheduled quarterly principal payments of the Term Loan B. As a result of these prepayments, we are not required to make a mandatory payment against the Term Loan B principal balance until maturity in August 2024.

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Additionally, during the nine months ended September 30, 2018 , we made mandatory principal payments of $18.8 million towards our Term Loan A.
Interest Rates
In May 2018, we entered into Amendment No. 1 (the “Repricing Amendment”) to the Credit Agreement dated August 1, 2017. The Repricing Amendment reduced the overall applicable margins with respect to both Term Loan A and Term Loan B by 0.25% .
Additionally, in June 2018, we entered into  two new interest rate swaps with multiple counterparties in an effort to limit our exposure to variable interest rates on our Term Loans. The first interest rate swap has an aggregate notional value of $1.22 billion , began accruing interest on June 29, 2018, and will expire on December 31, 2018. The second interest rate swap has an aggregate notional value of $1.01 billion , an effective date of December 31, 2018, and will expire on June 30, 2021. As a result, the percentage of the our total principal debt (excluding capital leases) that is subject to fixed interest rates was approximately 56% at September 30, 2018 . Each quarter-point increase or decrease in the applicable interest rate at September 30, 2018 would change our annual interest expense by approximately $3.1 million .
Covenant restrictions under our Lease Agreement
The lease agreement for our new corporate headquarters in Morrisville, North Carolina includes a provision that requires us to issue a letter of credit in certain amounts to the landlord based on our debt rating issued by Moody’s Investors Service (or other nationally-recognized debt rating agency). As of September 30, 2018 (and through the date of this filing), our credit rating was Ba3. As such, no letter of credit is required through the date of this filing. Any letters of credit issued in accordance with the aforementioned requirements would be issued under our Revolver, and would reduce its available borrowing capacity by the same amount.
Our ability to make payments on our indebtedness and to fund planned capital expenditures and necessary working capital will depend on our ability to generate cash in the future. Our ability to meet our cash needs through cash flows from operations will depend on the demand for our services, as well as general economic, financial, competitive, and other factors, many of which are beyond our control. Our business may not generate cash flow in an amount sufficient to enable us to pay the principal of, or interest on, our indebtedness, or to fund our other liquidity needs, including working capital, capital expenditures, acquisitions, investments, and other general corporate requirements. If we cannot fund our liquidity needs, we will have to take actions such as reducing or delaying capital expenditures, acquisitions or investments, selling assets, restructuring or refinancing our debt, reducing the scope of our operations and growth plans, or seeking additional capital. We cannot assure you that any of these remedies could, if necessary, be affected on commercially reasonable terms, or at all, or that they would permit us to meet our scheduled debt service obligations. Our 2017 Credit Agreement contains covenant restrictions that limit our ability to direct the use of proceeds from any disposition of assets and, as a result, we may not be allowed to use the proceeds from any such dispositions to satisfy all current debt service obligations.
Accounts Receivable Financing Agreement
On June 29, 2018 we entered into an accounts receivable financing agreement (as amended) with a termination date of June 29, 2020, unless terminated earlier pursuant to its terms. Under this agreement, we can borrow up to  $250.0 million  from a third-party lender, secured by liens on certain receivables and other assets. As of September 30, 2018 , we had $183.6 million of outstanding borrowings under this agreement with a maximum remaining borrowing capacity available of $66.4 million , which is limited by a periodic calculation of our available borrowing base.

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2018 Stock Repurchase Program
On February 26, 2018, our Board of Directors authorized the repurchase of up to an aggregate of  $250.0 million  of our common stock, par value $0.01 per share, to be executed from time to time in open market transactions effected through a broker at prevailing market prices, in block trades, or privately negotiated transactions. The stock repurchase program commenced on March 1, 2018 and will end no later than December 31, 2019. We intend to use cash on hand and future free cash flow to fund the stock repurchase program.
In March 2018, we repurchased 948,100 shares of our common stock in open market transactions at an average price of $39.55 per share, resulting in a total purchase price of approximately  $37.5 million . In April 2018, we repurchased 1,024,400 shares of our common stock in open market transactions at an average price of $36.60 per share, resulting in a total purchase price of approximately  $37.5 million . We immediately retired all of the repurchased common stock. As of  September 30, 2018 , we had remaining authorization to repurchase up to approximately $175.0 million  of shares of our common stock under the 2018 stock repurchase program.
We are not obligated to repurchase any particular amount of our common stock, and the stock repurchase program may be modified, extended, suspended or discontinued at any time. The timing and amount of repurchases is determined by our management based on a variety of factors such as our corporate requirements for cash, overall market conditions, and the market price of our common stock. The stock repurchase program will be subject to applicable legal requirements, including federal and state securities laws.
Cash and Cash Equivalents
Our cash flows from operating, investing, and financing activities were as follows (in thousands):
 
Nine Months Ended
 
 
 
September 30, 2018
 
September 30, 2017
 
Change
Net cash provided by operating activities
$
191,000

 
$
109,746

 
$
81,254

Net cash used in investing activities
(133,853
)
 
(1,706,427
)
 
1,572,574

Net cash (used in) provided by financing activities
(246,677
)
 
1,790,248

 
(2,036,925
)
Cash Flows from Operating Activities
For the nine months ended September 30, 2018 , our operating activities provided $191.0 million in cash, consisting of net loss of $21.4 million , adjusted for net non-cash items of $221.2 million primarily related to depreciation and amortization expense, share-based compensation expense, and foreign currency adjustments. Cash used for changes in operating assets and liabilities was $8.8 million , consisting primarily of cash outflows as a result of a net increase in accounts receivable, unbilled services, and advanced billings, partially offset by a decrease in other assets and liabilities.
For the nine months ended September 30, 2017, our operating activities provided $109.7 million in cash, consisting of net loss of $123.4 million, adjusted for net non-cash items of $200.3 million primarily related to depreciation and amortization, share-based compensation, asset impairment charges and foreign currency adjustments. Additionally, cash provided by changes in operating assets and liabilities was $32.9 million, consisting primarily of cash inflow as a result of a decrease in billed and unbilled accounts receivable, partially offset by an increase in deferred revenue and accounts payable and accrued expenses.
Cash flows from operations increased by $81.3 million during the nine months ended September 30, 2018 , compared to the nine months ended September 30, 2017 , due to the year-over-year decrease in net loss of $102.0 million and an increase in non-cash items of $20.9 million largely due to the increase in depreciation and amortization expenses associated with the Merger. Partially offsetting this increase was

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a decrease in operating assets and liabilities of $41.7 million compared to the prior year. The changes in operating assets and liabilities result primarily from the net change in billed and unbilled accounts receivable, contract assets and contract liabilities, coupled with changes in accounts payable and other long-term assets and liabilities. Fluctuations in billed and unbilled receivables, contract assets and contract liabilities occur on a regular basis as we perform services, achieve milestones or other billing criteria, send invoices to customers and collect outstanding accounts receivable. This activity varies by individual customer and contract. We attempt to negotiate payment terms that provide for payment of services prior to or soon after the provision of services, but the levels of unbilled services, contract assets and contract liabilities can vary significantly from period to period.
As a result of our integration activities associated with the Merger and our acquisition activity, we incurred substantial expenses which negatively impacted our cash flow from operations. For example, during the nine months ended September 30, 2018 , we incurred $56.5 million of expenses which impacted our operating cash flows in the current period or will impact operating cash flows in the future. We anticipate that we will continue to incur similar costs related to our integration efforts for the next 12 to 18 months.
Cash Flows from Investing Activities
For the nine months ended September 30, 2018 , we used $133.9 million in cash for investing activities. In particular, we paid $90.9 million , net of cash acquired for an acquisition and incurred capital expenditures related to purchases of property and equipment of $43.0 million during the period. For the full year 2018 , we expect our total capital expenditures to be between $75.0 million and $80.0 million . This estimate includes expenditures associated with planned consolidation of our corporate headquarters facility in Morrisville, North Carolina, as well as expenditures related to our site in Farnborough, United Kingdom which replaced our Camberley, United Kingdom location. These moves are expected to be completed by early 2019, which coincides with the expiration of our existing leases.
For the nine months ended September 30, 2017, we used $1.7 billion in cash for investing activities. In particular, as part of the Merger consideration and on behalf of inVentiv, we repaid $1.7 billion of inVentiv’s outstanding long term debt obligations and associated accrued interest. This cash outflow was partially offset by $57.3 million of cash acquired as part of the Merger. In addition, our capital expenditures related to purchases of property and equipment used $28.2 million of cash during the period.
Cash Flows from Financing Activities
For the nine months ended September 30, 2018 , our financing activities used $246.7 million in cash, consisting primarily of: (i) repayments of long-term debt of $354.4 million , including voluntary prepayments of $299.0 million against the principal balance of our Term Loan B and $36.6 million used to repay the debt obligations assumed in the acquisition of Kinapse; (ii) payments of $75.0 million for the repurchase of our common stock under the 2018 repurchase program; and (iii) repayments of capital lease obligations of $12.7 million . These payments were partially offset by proceeds of: (i) $183.6 million from our accounts receivable financing agreement; and (ii) $18.0 million  received from the exercise of stock options.
For the nine months ended September 30, 2017, our financing activities provided $1.8 billion in cash, consisting primarily of: (i) net proceeds of $2.1 billion from the issuance of long-term debt under our 2017 Credit Agreement; and (ii) proceeds of $17.0 million from the exercise of stock options. These cash inflows were partially offset by: (i) partial redemption of the Senior Notes assumed in the Merger and payment of the associated early redemption penalty totaling $290.3 million; and (ii) net repayments of $25.0 million under our revolving line of credit.

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Contractual Obligations and Commitments
We do not have any off-balance sheet arrangements except for operating leases entered into in the normal course of business. There have been no material changes, outside of the ordinary course of business, to our contractual obligations as previously disclosed in our Annual Report on Form 10-K for the fiscal year ended  December 31, 2017 .
Critical Accounting Policies and Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates, judgments, and assumptions that affect the reported amounts of assets and liabilities, revenues, and expenses during the period, as well as disclosures of contingent assets and liabilities at the date of the financial statements. We evaluate our estimates on an ongoing basis, including those related to revenue recognition, share-based compensation, valuation of goodwill and identifiable intangibles, tax-related contingencies and valuation allowances, allowance for doubtful accounts, and litigation contingencies, among others. These estimates are based on the information available to management at the time these estimates, judgments and assumptions are made. Actual results may differ materially from these estimates. The following policies have been updated as a result of the adoption Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers (“ASC 606”). For additional information on all of our critical accounting policies and estimates, refer to Part II - Item 7 - Management’s Discussion and Analysis included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2017 .
Revenue Recognition
We adopted the ASC 606 - Revenue from Contracts with Customers and all the related amendments (“new revenue standard” or “ASC 606”) on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. Our reported results for the three and nine months ended September 30, 2018 reflect the application of ASC 606, while the reported results for the three and nine months ended September 30, 2017 were prepared under ASC 605 - Revenue Recognition and other authoritative guidance in effect for this period. In accordance with ASC 606, revenue is now recognized when, or as, a customer obtains control of promised services. The amount of revenue recognized reflects the consideration to which we expect to be entitled to receive in exchange for these services.
A performance obligation is a promise (or a combination of promises) in a contract to transfer distinct goods or services to a customer and is the unit of accounting under ASC 606 for the purposes of revenue recognition. A contract’s transaction price is allocated to each separate performance obligation based upon the standalone selling price and is recognized as revenue, when, or as, the performance obligation is satisfied. The majority of our contracts have a single performance obligation because the promise to transfer individual services is not separately identifiable from other promises in the contracts, and therefore, is not distinct. For contracts with multiple performance obligations, the contract’s transaction price is allocated to each performance obligation using the best estimate of the standalone selling price of each distinct good or service in the contract.
The majority of our revenue arrangements are service contracts that range in duration from a few months to several years. Substantially all of our performance obligations, and associated revenue, are transferred to the customer over time. We generally receive compensation based on measuring progress toward completion using anticipated project budgets for direct labor and prices for each service offering. We are also reimbursed for certain third-party pass-through and out-of-pocket costs. In addition, in certain instances a customer contract may include forms of variable consideration such as incentive fees, volume rebates or other provisions that can increase or decrease the transaction price. This variable consideration is generally awarded upon achievement of certain performance metrics, program milestones or cost targets. For the purposes of revenue recognition, variable consideration is assessed on a contract-by-contract basis and the amount to be recorded is estimated based on the assessment of our anticipated performance and consideration of all information that is reasonably available. Variable consideration is recognized as revenue if and when it is deemed probable that a significant reversal in the

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amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved in the future.
Most of our contracts can be terminated by the customer without cause with a 30-day notice. In the event of termination, our contracts generally provide that the customer pay us for fees earned through the termination date; fees and expenses for winding down the project, which include both fees incurred and actual expenses; non-cancellable expenditures; and in some cases, a fee to cover a portion of the remaining professional fees on the project. Our long term clinical trial contracts contain implied substantive termination penalties because of the significant wind-down cost of terminating a clinical trial. These provisions for termination penalties result in these types of contracts being treated as long term for revenue recognition purposes.
Changes in the scope of work are common, especially under long-term contracts, and generally result in a renegotiation of future contract pricing terms and change in contract transaction price. If the customer does not agree to a contract modification, we could bear the risk of cost overruns. Most of our contract modifications are for services that are not distinct from the services under the existing contract due to the significant integration service provided in the context of the contract and therefore result in a cumulative catch-up adjustment to revenue at the date of contract modification.
Contract Assets and Liabilities
Contract assets include unbilled amounts typically resulting from revenue recognized in excess of the amounts billed to the customer for which the right to payment is subject to factors other than the passage of time. These amounts may not exceed their net realizable value. Contract assets are generally classified as current. Contract liabilities consist of customer payments received in advance of performance and billings in excess of revenue recognized, net of revenue recognized from the balance at the beginning of the period. Contract assets and liabilities are presented on the balance sheet net on a contract-by-contract basis at the end of each reporting period.
Recently Issued Accounting Standards
For a description of recently issued accounting pronouncements, including the expected dates of adoption and the estimated effects, if any, on our unaudited condensed consolidated financial statements, refer to “Note 1 - Basis of Presentation and Changes in Significant Accounting Policies to our unaudited condensed consolidated financial statements in Part I, Item 1 of this Quarterly Report on Form 10-Q.
Item 3. Quantitative and Qualitative Disclosures About Market Risk.
There have been no material changes to our quantitative and qualitative disclosures about market risk as compared to the quantitative and qualitative disclosures about market risk described in our Annual Report on Form 10-K for the fiscal year ended  December 31, 2017 .

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Item 4. Controls and Procedures.
Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our CEO and CFO, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the Exchange Act), as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on such evaluation, our CEO and CFO have concluded that as of such date, our disclosure controls and procedures were effective.
In designing and evaluating the disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures must reflect the fact that there are resource constraints and that management is required to apply judgment in evaluating the benefits of possible controls and procedures relative to their costs.
Changes in Internal Controls
As previously noted, we completed the Merger with inVentiv during the third quarter of 2017. Management considers this transaction to be material to our consolidated financial statements and believes that the internal controls and procedures of inVentiv have a material effect on our internal control over financial reporting. We are currently in the process of incorporating the internal controls and procedures of inVentiv into our internal controls over financial reporting and extending our Section 404 compliance program under the Sarbanes-Oxley Act of 2002 and the applicable rules and regulations under such Act to include inVentiv. We will report on our assessment of the consolidated operations within the time period provided by the Act and the applicable SEC rules and regulations concerning business combinations, which is the annual management report for the fiscal year ending December 31, 2018. 
During the third quarter of 2018, we implemented an enterprise resource planning (“ERP”) system for several subsidiaries in our Commercial Solutions segment as part of our multi-year implementation plan. We expect that the ERP system will enhance the overall system of internal controls over financial reporting through further automation and business process integration.
There have been no changes, except as otherwise described above, in our internal control over financial reporting identified in management’s evaluation pursuant to Rules 13a-15(d) or 15d-15(d) of the Exchange Act during the period covered by this Quarterly Report on Form 10-Q that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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PART II. OTHER INFORMATION
Item 1. Legal Proceedings.
We are party to legal proceedings incidental to our business. While our management currently believes the ultimate outcome of these proceedings, individually and in the aggregate, will not have a material effect on our unaudited condensed consolidated financial statements, litigation is subject to inherent uncertainties. Were an unfavorable ruling to occur, there exists the possibility of a material adverse impact on our financial condition and results of operations.
On December 1, 2017, the first of two virtually identical actions alleging federal securities law claims was filed against us and certain of our officers on behalf of a putative class of our shareholders. The first action, captioned Bermudez v. INC Research, Inc., et al, No. 17-09457 (S.D.N.Y.), names as defendants us, Michael Bell, Alistair MacDonald, Michael Gilbertini, and Gregory S. Rush, and the second action, Vaitkuvienë v. Syneos Health, Inc., et al, No. 18-0029 (E.D.N.C.), filed on January 25, 2018, names as defendants us, Alistair MacDonald, and Gregory S. Rush. Both complaints allege similar claims under Section 10(b) and Section 20(a) of the Securities Exchange Act of 1934 on behalf of a putative class of purchasers of our common stock between May 10, 2017 and November 8, 2017 (Vaitkuvienë action) and November 9, 2017 (Bermudez action). The complaints allege that we published inaccurate or incomplete information regarding, among other things, the financial performance and business outlook for inVentiv’s business prior to the Merger and with respect to the combined company following the Merger. On January 30, 2018, two alleged shareholders of ours filed motions both seeking to be appointed lead plaintiff and approving the selection of lead counsel. These motions remain pending. On March 30, 2018, Plaintiff Bermudez filed a notice of voluntary dismissal of the Bermudez action, without prejudice, and as to all defendants. On May 29, 2018, the Court in the Vaitkuvienë action appointed the San Antonio Fire & Police Pension Fund and El Paso Firemen & Policemen’s Pension Fund as Lead Plaintiffs and, on June 7, 2018, the Court entered a schedule providing for, among other things, Lead Plaintiffs to file an amended complaint by July 23, 2018 (later extended to July 30, 2018). Lead Plaintiffs filed their amended complaint on July 30, 2018, which also includes a claim against the same defendants listed above, as well as each member of the board of directors at the time of the INC Research - inVentiv Health merger vote in July 2017, contending that the inVentiv merger proxy was misleading under Section 14(a) of the Act. Defendants filed a Motion to Dismiss Plaintiffs’ Amended Complaint on September 20, 2018. We and the other defendants deny the allegations in these complaints and intend to defend vigorously against these claims.
Item 1A. Risk Factors.
There have been no significant changes from the risk factors previously disclosed in our Annual Report on Form 10-K for the year ended December 31, 2017 . Refer to “Risk Factors” in Part 1, Item 1A of that report for a detailed discussion of risk factors affecting the Company.

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Item 2. Unregistered Sales of Equity Securities, Use of Proceeds and Issuer Purchases of Equity Securities.
Recent Sales of Unregistered Securities
Not applicable.
Use of Proceeds from Registered Securities
Not applicable.
Purchases of Equity Securities by the Issuer
On February 26, 2018, the Board authorized the repurchase of up to an aggregate of  $250.0 million  of our common stock, par value $0.01 per share, from time to time in open market transactions effected through a broker at prevailing market prices, in block trades, or privately negotiated transactions. The stock repurchase program commenced on March 1, 2018 and will end no later than December 31, 2019. We intend to use cash on hand and future free cash flow to fund the stock repurchase program. The stock repurchase program does not obligate us to repurchase any particular amount of our common stock, and may be modified, extended, suspended or discontinued at any time. The timing and amount of repurchases is determined by our management based on a variety of factors such as the market price of our common stock, our corporate requirements, and overall market conditions. The stock repurchase program is subject to applicable legal requirements, including federal and state securities laws. We may also repurchase shares of our common stock pursuant to a trading plan meeting the requirements of Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, which would permit shares of our common stock to be repurchased when we might otherwise be precluded from doing so by law.
In March 2018, we repurchased 948,100 shares of our common stock in open market transactions at an average price of $39.55 per share, resulting in a total purchase price of approximately  $37.5 million . In April 2018, we repurchased 1,024,400 shares of our common stock in open market transactions at an average price of $36.60 per share, resulting in a total purchase price of approximately  $37.5 million . As of  September 30, 2018 , we have remaining authorization to repurchase up to approximately $175.0 million  of shares of our common stock under the stock repurchase program.
There were no share repurchases under the stock repurchase program for the three months ended  September 30, 2018 .
Item 5. Other Information.
Not applicable.

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Item 6. Exhibits
 
 
 
Incorporated by Reference (Unless Otherwise Indicated)
Exhibit Number   
 
Exhibit Description
Form    
File No.    
Exhibit    
Filing Date    
10.1
 
Filed herewith
10.2
 
Filed herewith
10.3
 
Filed herewith
31.1
 
Filed herewith
31.2
 
Filed herewith
32.1
 
Furnished herewith
32.2
 
Furnished herewith
101.INS
 
XBRL Instance Document.
Filed herewith
101.SCH
 
XBRL Taxonomy Extension Schema Document.
Filed herewith
101.CAL
 
XBRL Taxonomy Extension Calculation Linkbase Document.
Filed herewith
101.DEF
 
XBRL Taxonomy Extension Definition Linkbase Document.
Filed herewith
101.LAB
 
XBRL Taxonomy Extension Label Linkbase Document.
Filed herewith
101.PRE
 
Taxonomy Extension Presentation Linkbase Document.
Filed herewith



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SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this Quarterly Report on Form 10-Q to be signed on its behalf by the undersigned, thereunto duly authorized in the City of Raleigh, State of North Carolina, on November 5, 2018 .
 
 
 
 
 
 
SYNEOS HEALTH, INC.
 
 
 
Date: November 5, 2018
 
/s/ Jason Meggs
 
 
Jason Meggs
 
 
Chief Financial Officer (Principal Financial and Accounting Officer)



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EXHIBIT INDEX
 
 
 
Incorporated by Reference (Unless Otherwise Indicated)
Exhibit Number   
 
Exhibit Description
Form    
File No.    
Exhibit    
Filing Date    
10.1
 
Syneos Health, Inc. Executive Severance Plan, Adopted September 15, 2016, amended and restated August 20, 2018.
Filed herewith
10.2
 
Second Amendment to the Receivables Financing Agreement, dated August 29, 2018 among Syneos Health Receivables LLC, as borrower, PNC Bank, National Association, as administrative agent and as lender and INC Research, LLC, as initial servicer.
Filed herewith
10.3
 
Third Amendment to the Receivables Financing Agreement, dated October 25, 2018 among Syneos Health Receivables LLC, as borrower, PNC Bank, National Association, as administrative agent and as lender and INC Research, LLC, as initial servicer.
Filed herewith
31.1
 
Certification of Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
Filed herewith
31.2
 
Certification of Chief Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
Filed herewith
32.1
 
Certification of Chief Executive Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
Furnished herewith
32.2
 
Certification of Chief Financial Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
Furnished herewith
101.INS
 
XBRL Instance Document.
Filed herewith
101.SCH
 
XBRL Taxonomy Extension Schema Document.
Filed herewith
101.CAL
 
XBRL Taxonomy Extension Calculation Linkbase Document.
Filed herewith
101.DEF
 
XBRL Taxonomy Extension Definition Linkbase Document.
Filed herewith
101.LAB
 
XBRL Taxonomy Extension Label Linkbase Document.
Filed herewith
101.PRE
 
Taxonomy Extension Presentation Linkbase Document.
Filed herewith




60

Exhibit 10.1

SYNEOS HEALTH, INC.
EXECUTIVE SEVERANCE PLAN
(Adopted September 15, 2016, amended and restated August 20, 2018)
The purpose of the Syneos Health, Inc. Executive Severance Plan, as amended from time to time (the “Plan”), is to better provide for the retention of key executives through providing them with a higher degree of financial security, on the terms and conditions hereinafter stated. The Plan is intended to be a severance pay plan governed by Title I of ERISA primarily for the purpose of providing benefits for a select group of management or highly compensated employees. All benefits under the Plan will be paid solely from the general assets of the Company. This Plan is an amendment and restatement, effective as of the Effective Date (as defined below), of the INC Research Holdings, Inc. Executive Severance Plan that was originally adopted on September 15, 2016. Any benefits payable for a Qualifying Termination for a Participant in the Plan that occurred before the Effective Date shall be determined under the terms of the Plan as in effect prior to the Effective Date.
ARTICLE I
DEFINITIONS
Section 1.01 Definitions . As used in this Plan, the following terms shall have the respective meanings set forth below:
(a) “Affiliate” means, with respect to any individual or entity, any other individual or entity who, directly or indirectly through one or more intermediaries, controls, is controlled by or is under common control with, such individual or entity.
(b) “Base Salary” means a Participant’s annual salary for all services rendered, as established by the Company’s Board, or by the Compensation Committee.
(c) “Beneficial Owner” means the definition ascribed to such term in Rule 13d-3 under the Exchange Act.
(d) “Board” means the Board of Directors of the Company.
(e) “Bonus” means the bonus(es) payable pursuant to the Company’s MIP or such other plan that provides for the payment of incentive bonuses as may be, from time to time, authorized by the Board.
(f) “Cause” means the occurrence of any of the following with respect to a Participant, unless otherwise defined in the Participant’s employment agreement with the Company or any of its Affiliates:
(i) the Participant’s breach of any fiduciary duty or legal or contractual obligation to the Company or to the Board;
(ii) the Participant’s failure to follow the reasonable instructions of the Board or Participant’s direct supervisor, provided, however, that such instruction is consistent with Participant’s duties and responsibilities, which breach, if curable, is not cured within ten (10) business days after notice to Participant or, if cured, recurs within one hundred and eighty (180) calendar days;

1


(iii) the Participant’s gross negligence, willful misconduct, fraud, insubordination or acts of dishonesty relating to the Company; or
(iv) the Participant’s commission of any misdemeanor solely relating to the Company or of any felony.
(g) “Change in Control” means, notwithstanding the definition of Change in Control (or similar term) in any other agreement or plan that may be applicable to the Participant, one of the following events, in all cases occurring only after the Effective Date:
(i) Any Person becomes the Beneficial Owner, directly or indirectly, of more than fifty percent (50%) of the combined voting power, excluding any Person who Beneficially Owns fifty percent (50%) or more of the voting power on the Effective Date of the Plan, of the then outstanding voting securities of the Company entitled to vote generally in the election of its directors (the “ Outstanding Company Voting Securities ”), including by way of merger, consolidation or otherwise; provided , however , that for purposes of this definition, the following acquisitions shall not constitute a Change in Control: (i) any acquisition of Outstanding Company Voting Securities directly from the Company, including, without limitation, a public offering of securities or (ii) any acquisition of Outstanding Company Voting Securities by the Company, including an acquisition by any employee benefit plan or related trust sponsored or maintained by the Company;
(ii) Consummation of a reorganization, merger, or consolidation to which the Company is a party or a sale or other disposition of all or substantially all of the assets of the Company (a “ Business Combination ”), unless, following such Business Combination: (i) any Persons who were the Beneficial Owners of Outstanding Company Voting Securities immediately prior to such Business Combination are the Beneficial Owners, directly or indirectly, of more than fifty percent (50%) of the combined voting power of the outstanding voting securities entitled to vote generally in the election of directors (or election of members of a comparable governing body) of the entity resulting from the Business Combination (including, without limitation, an entity which, as a result of such transaction, owns all or substantially all of the Company or all or substantially all of the Company’s assets, either directly or through one or more Affiliates) (the “ Successor Entity ”) in substantially the same proportions as their ownership immediately prior to such Business Combination; or (ii) no Person (excluding any Successor Entity or any employee benefit plan or related trust of the Company, such Successor Entity or any of its Affiliates) is the Beneficial Owner, directly or indirectly, of more than fifty percent (50%) of the combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors (or comparable governing body) of the Successor Entity, except to the extent that such ownership of the Company existed prior to the Business Combination; or
(iii) Approval by the stockholders of the Company of a complete liquidation or dissolution of the Company.
A transaction shall not constitute a Change in Control if it is effected for the purpose of changing the place of incorporation, tax residency or form of organization of the ultimate parent entity (including where the

2


ultimate parent entity is succeeded by an entity incorporated under the laws of another state, country or foreign government for such purpose and whether or not the former ultimate parent entity remains in existence following such transaction) and where the stockholders of the Company immediately prior to any such transaction own (or continue to own by remaining outstanding or by being converted into voting securities of the successor parent entity) more than 50% of the combined voting power of the former ultimate parent entity or the successor ultimate parent entity immediately following such transaction, in substantially the same proportion to each other as prior to such transaction.    
(h) “CIC Period” means the period commencing the date three (3) months prior to a Change in Control and ending twenty-four (24) months following such Change in Control.
(i) “COBRA” means the Consolidated Omnibus Budget Reconciliation Act of 1985.
(j) “Code” means the Internal Revenue Code of 1986, as amended.
(k) “Company” means Syneos Health, Inc., a Delaware corporation, and its Affiliates, and any successor corporation thereto.
(l) “Company Change” means any merger, consolidation or corporate reorganization of the Company.
(m) “Compensation Committee” means the compensation committee of the Board.
(n) “Date of Termination” means the date on which a Participant’s employment by the Company or any of its Affiliates terminates.
(o) “Disability” means: (i) the definition ascribed to such term under a Participant’s employment agreement, or (ii) in the absence of such an employment agreement definition, a Participant’s physical or mental illness, injury or infirmity which is reasonably likely to prevent and/or prevents the Participant from performing his or her essential job functions for a period of (A) ninety (90) consecutive calendar days or (B) an aggregate of one hundred twenty (120) calendar days out of any consecutive twelve (12)-month period.
(p) “Dodd-Frank Act” means the Dodd-Frank Wall Street Reform and Consumer Protection Act.
(q) “Effective Date” means August 20, 2018, the effective date of the Plan.
(r) “Eligible Executive” means a full-time employee of the Company or one of its Affiliates who has been designated by the Plan Administrator to be eligible for benefits under the Plan. Eligible Executives shall be limited to a select group of management or highly compensated employees within the meaning of ERISA Sections 201, 301, and 404.
(s) “Equity Award” means an award covering the common stock of the Company granted under any equity incentive plan maintained by the Company from time to time under which a Participant has been granted equity incentive awards, including, without limitation, (i) the INC Research Holdings, Inc. 2010 Equity Incentive Plan, (ii) the INC Research Holdings, Inc. 2014 Equity Incentive Plan, (iii) the 2018

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Syneos Health, Inc. Equity Incentive Plan, as amended from time to time, or (iv) any successor plan(s) thereto.
(t) “Equity Award Agreement” means the agreement evidencing, and governing the terms of, an Equity Award.
(u) “ERISA” means the Employee Retirement Income Security Act of 1974, as amended.
(v) “Exchange Act” means the Securities Exchange Act of 1934, as amended.
(w) “Excise Tax” means the excise tax imposed by Code Section 4999.
(x) “Good Reason” means the occurrence, without Participant’s express written consent, of any of the following events with respect to the Participant, unless otherwise defined in the Participant’s employment agreement, if any:
    (i) a material reduction in the Participant’s Base Salary;
(ii) a material adverse change to the Participant’s title;
(iii) a requirement that the Participant relocate to a principal place of employment more than fifty (50) miles from the Participant’s current office location; or
(iv) a material breach by the Company of the terms of the employment agreement, if any, with the Participant.
For purposes of this Plan, any event described above shall constitute Good Reason only if: (A) the Participant provides the Company with written notice of the basis for the Participant’s Good Reason within forty-five (45) days of the initial actions or inactions of the Company giving rise to such Good Reason; (B) the Company has not cured the identified actions or inactions within sixty (60) days of such notice; and (C) the Participant’s Date of Termination is no later than thirty (30) days after the cure period has expired, unless otherwise agreed to by the Company.
(y) “MIP” means the Company’s Management Incentive Plan, as may be amended from time to time, or any other plan or program that is a successor to the MIP.
(z) “Non-CIC Period” means the period prior to or following a CIC Period.
(aa) “Nonqualifying Termination” means a termination of the Participant’s employment other than a Qualifying Termination.
(bb) “Participant” means any Eligible Executive who is selected to be a participant in the Plan by action of the Plan Administrator as specified herein.
(cc) “Person” means the definition ascribed to such term in Section 3(a)(9) of the Exchange Act and used in Sections 13(d) and 14(d) thereof, including a “group” as defined in Section 13(d) thereof.
(dd) “Post-Employment Restrictive Covenants and other Obligations” means the restrictive covenant and other obligations applicable to Participant and contained in the Participant’s employment

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agreement or any other Company agreement or policy, including the provisions governing confidentiality; non-solicitation of customers and other business relations, non-solicitation of employees; non-disparagement; non-competition; intellectual property developments; and cooperation.
(ee) “Plan Administrator” means the Compensation Committee of the Board, or, if the Board so determines, another committee of the Board or the Board itself.
(ff) “Qualifying Termination” means a (i) termination of the Participant’s employment by the Company other than for Cause, death or Disability, or (ii) termination of the Participant’s employment as a result of a resignation by the Participant for Good Reason.
(gg) “Release” means the waiver and release of claims substantially in the form attached hereto as Exhibit A.
(hh) “Separation from Service” means a “separation from service” within the meaning of Code Section 409A.
(ii) “Target Bonus Amount” means, with respect to any Year, the amount of the target bonus for such Year that is established for the Participant under the MIP.
(jj) “Year” means the fiscal year of the Company.
ARTICLE II
PARTICIPATION AND SCOPE OF SEVERANCE BENEFITS
Section 2.01 Participation in the Plan . The Plan Administrator may designate any Eligible Executive to be a Participant, provided that only the Compensation Committee or the Board shall have the authority to designate Participants that will be eligible to receive benefits. The Plan Administrator may vary the terms of a Participant’s participation on a case-by-case basis. Promptly following such designation, each Participant shall be notified of his or her participation in a formal communication from the Plan Administrator or the Company. Participation in the Plan shall be determined in the Plan Administrator’s sole discretion. Once participation in the Plan has commenced, a Participant shall remain a Participant until the first to occur of (i) a Nonqualifying Termination and (ii) the completion of the delivery of all benefits under the Plan following a Qualifying Termination under circumstances giving rise to a right to such benefits.
Section 2.02 Conditions .
As a condition precedent to entitlement of each Participant to benefits under Sections 3.01 and 3.02 of the Plan, the Participant agrees to each of the following:
(a) The Participant shall have executed, within twenty-one (21) days, or if required for an effective release, forty-five (45) days, following the Participant’s Date of Termination, the Release, and the applicable revocation period set forth in such release shall have expired. For the avoidance of any doubt, the Release shall supersede and replace in its entirety, any other release required to be executed under any employment agreement or other arrangement with the Participant.

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(b) The Participant agrees to execute a resignation letter stating that effective as of the Participant’s Date of Termination, or such earlier date as required or requested by the Company, the Participant resigns as any officer or director position with the Company or any of its Affiliates of which he or she is a member and/or to which he or she has been appointed.
(c) The Participant’s shall reaffirm his or her agreement to abide by the Post-Employment Restrictive Covenants and Other Obligations.
Section 2.03 No Duty to Mitigate . A Participant shall not be required to mitigate the amount of any payment or benefit provided for in the Plan by seeking other employment or otherwise and no such payment or benefit shall be offset or reduced by the amount of any compensation or benefits provided to the Participant in any subsequent employment.
Section 2.04 Non-duplication . The Company does not intend to duplicate severance benefits. Accordingly, the severance payments and benefits under the Plan to a Participant shall be reduced by any severance benefits to which the Participant would otherwise be entitled under the Participant’s employment agreement, or any general severance policy or plan maintained by the Company that provides for severance benefits (unless the agreement, policy or plan expressly provides for severance benefits to be in addition to those provided under the Plan). The severance payments and benefits to which a Participant is otherwise entitled shall be further reduced (but not below zero) by any payments or benefits to which the Participant may be entitled under any federal, state or local plant-closing (or similar or analogous) law (including, without limitation, the U.S. Worker Adjustment and Retraining Notification Act). Any such reductions or offsets in severance benefits shall be made in a manner that complies with Code Section 409A (if applicable).
ARTICLE III
TERMINATION BENEFITS
Section 3.01 Qualifying Termination During a Non-CIC Period . If a Participant incurs a Qualifying Termination and his or her Date of Termination is during a Non-CIC Period, then the Participant shall be entitled to the following (which shall be payable in accordance with Article IV):
(a) an amount equal to the sum of (i) the Participant’s Base Salary from the Company and its Affiliates through the Date of Termination, (ii) any outstanding Bonus for which payment is due and owing as of the Date of Termination, (iii) any paid time off pay that is accrued and unused as of the Date of Termination, and (iv) any unreimbursed expenses properly incurred by the Participant in accordance with the Company’s business expense reimbursement policy.
(b) an amount equal to one hundred percent (100%) of the sum of (i) the Participant’s Base Salary as in effect on the Date of Termination, and (ii) the Participant’s Target Bonus Amount for the Year in which the Date of Termination occurs.
(c) To the extent the Participant timely elects benefit continuation coverage under COBRA, an amount equal to the aggregate amount of the full premium (i.e., the Participant and Company’s portion) for benefit coverage continuation under COBRA as provided under the Company’s group health plans in effect for the Participant and his or her eligible dependents who are participating in the Company’s group health

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plans as of immediately prior to the Date of Termination for a period of twelve (12) months. (For the avoidance of any doubt, the cash amount payable pursuant to this Section 3.01(c) shall be includible in the Participant’s income and shall supersede and be in lieu of any amounts payable to the Participant pursuant to the Participant’s employment agreement or any other arrangement providing for the payment of COBRA continuation coverage for the Participant.)
Section 3.02 Qualifying Termination During a CIC Period . If a Participant incurs a Qualifying Termination and his or her Date of Termination is during a CIC Period, then the Participant shall be entitled to the following (which shall be payable in accordance with Article IV):
(a) An amount equal to the sum of (i) the Participant’s Base Salary from the Company and its Affiliates through the Date of Termination, (ii) any outstanding Bonus for which payment is due and owing as of the Date of Termination, (iii) any paid time off pay that is accrued and unused as of the Date of Termination, and (iv) any unreimbursed expenses properly incurred by the Participant in accordance with the Company’s business expense reimbursement policy;
(b) An amount equal to two hundred percent (200%) of the sum of (i) the Participant’s Base Salary as in effect on the Date of Termination, and (ii) the Participant’s Target Bonus Amount for the Year in which the Date of Termination occurs.
(c) To the extent the Participant timely elects benefit continuation coverage under COBRA, an amount equal to the aggregate amount of the full premium (i.e., the Participant and Company’s portion) for benefit coverage continuation under COBRA as provided under the Company’s group health plans in effect for the Participant and his or her eligible dependents who are participating in the Company’s group health plans as of immediately prior to the Date of Termination for a period of twenty-four (24) months. (For the avoidance of any doubt, the cash amount payable pursuant to this Section 3.02(c) shall be includible in the Participant’s income and shall supersede and be in lieu of any amounts payable to the Participant pursuant to the Participant’s employment agreement or any other arrangement providing for the payment of COBRA continuation coverage for the Participant).
(d) Any unvested Equity Awards will become fully vested and, if applicable, such Equity Award shall remain exercisable for the period set forth in the agreement evidencing the grant of the Equity Award. For the avoidance of any doubt, the provisions of this Section 3.02(d) shall supersede the provisions contained in the agreements evidencing the grant of the Equity Awards, provided that the provisions of the Equity Awards will control to the extent such provisions are more favorable to the Participant. In the case of any performance-based Equity Awards, “full vesting” means vesting based on the level of performance adjustment determined under the terms of the applicable Equity Award agreement in connection with the Change in Control.
ARTICLE IV
FORM AND TIME OF PAYMENT
Section 4.01 Payments of Accrued Items for a Qualifying Termination . The payments contemplated under Sections 3.01(a) and 3.02(a) shall be made as soon as practicable, but no later than sixty (60) days after the Participant’s Date of Termination.

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Section 4.02 Payments for a Qualifying Termination During a Non-CIC Period . The amounts contemplated under Sections 3.01(b) and 3.01(c) shall be paid in accordance with the Company’s regular pay schedule in substantially equal installments over a period of twelve (12) months following the Participant’s Date of Termination. The payments described above will be conditioned on the Participant providing the Company with (and not revoking) a Release, no later than sixty (60) days after the Participant’s Date of Termination. Any payments will commence in the next pay period after the Release becomes effective (not more than seventy-five (75) days after the Participant’s Date of Termination), including a lump sum for any payments for any payroll periods from the Date of Termination through the date the Release becomes effective.
Section 4.03 Payments for a Qualifying Termination During a CIC Period . The amounts contemplated under Section 3.02(b) and 3.02(c) shall be paid in a lump sum after the later of the date of the Change in Control or the Participant’s Date of Termination. The payments described above will be conditioned on the Participant providing the Company with (and not revoking) a Release, no later than sixty (60) days after the Participant’s Date of Termination. The lump sum payable to a Participant under this Section 4.03 will be paid in the next pay period after the Release becomes effective (not more than seventy-five (75) days after the Participant’s Date of Termination). Notwithstanding the foregoing, in the case of a Qualifying Termination during a CIC Period but before the Change in Control occurs, the difference between (i) the sum of the amounts stated in Sections 3.02(b) and 3.02(c) and (ii) the sum of the amounts stated in Sections 3.01(b) and 3.01(c) shall be conditioned on the closing of the Change in Control occurring within three (3) months after the Participant’s Date of Termination. If the Change in Control occurs within three (3) months after the Participant’s Date of Termination, the amounts payable under Sections 3.02(b) and 3.02(c) (reduced by any amounts that had been paid under Section 3.01(b) and 3.01(c) before the date of the Change in Control) shall be paid as soon as practicable (and not more than sixty (60) days) after the date of the Change in Control, assuming the Participant satisfies the Release condition.
Section 4.04 Treatment of Equity Awards in a Qualifying Termination During a CIC Period . Equity Awards granted in the form of restricted stock units (time-based and performance-based) that vest pursuant to Section 3.02(d) shall be settled within 60 days after the later of the date of the Change in Control or the Participant’s Date of Termination, provided that the Participant has executed the Release and the revocation period has expired within such 60-day period.
ARTICLE V
AMENDMENT / TERMINATION OF PLAN
Section 5.01 Plan Amendment and Termination . This Plan may be amended by action of the Board, provided that any amendment that materially and adversely impacts the right of a Participant under the Plan shall not become effective without the Participant’s written consent. The Plan may not be terminated without the Participant’s written consent.
ARTICLE VI
FEDERAL EXCISE TAX UNDER SECTION 4999 OF THE CODE
Section 6.01 Parachute Payments . In the event that the benefits provided for in this Plan (together with any other benefits or amounts) otherwise constitute “parachute payments” within the meaning of Code

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Section 280G and would, but for this Article VI be subject to the Excise Tax, then the Participant’s benefits under this Plan shall be either: (i) delivered in full, or (ii) delivered as to such lesser extent as would result in no portion of such benefits being subject to the Excise Tax, whichever of the foregoing amounts, taking into account the applicable federal, state and local income taxes and the Excise Tax, results in the receipt by the Participant on an after-tax basis, of the greatest amount of benefits, notwithstanding that all or some portion of such benefits may be taxable under Code Section 4999. In the event of a reduction of benefits hereunder, the Accountants (as defined below) shall determine which benefits shall be reduced so as to achieve the principle set forth in the preceding sentence.
Section 6.02 Parachute Payment Determinations . Unless the Company and the Participant otherwise agree in writing, all determinations required to be made under this Article VI, including the manner and amount of any reduction in the Participant’s benefits under this Plan, and the assumptions to be utilized in arriving at such determinations, shall be promptly determined and reported in writing to the Company and the Participant by Deloitte or such other independent public accountants or other independent advisors selected by the Company that are not serving as the accountants or auditors for the individual, entity or group effecting the Change in Control (the “ Accountants ”), and all such computation and determinations shall be conclusive and binding upon the Participant and the Company. All fees and expenses of the Accountants shall be borne solely by the Company, and the Company shall enter into any agreement requested by the Accountants in connection with the performance of the services hereunder. For purposes of making the calculations required by this Article VI, the Accountants may make reasonable assumptions and approximations concerning the application of Code Sections 280G and 4999. The Company and the Participant shall furnish to the Accountants such information and documents as the Accountants may reasonably request to make a determination under this Article VI.
Section 6.03 Applicable Federal Rate . As expressly permitted by Q/A #32 of the Treasury Regulations under Code Section 280G, with respect to performing any present value calculations that are required in connection with this Article VI, the Participant and the Company each affirmatively elect to utilize the Applicable Federal Rates (“ AFR ”) that are in effect as of the date this Plan is adopted and the Accountants shall therefore use such AFR in their determinations and calculations.
ARTICLE VII
MISCELLANEOUS PROVISIONS
Section 7.01 Plan Administration . The Plan Administrator shall administer the Plan and may interpret the Plan, prescribe, amend and rescind rules and regulations under the Plan and make all other determinations necessary or advisable for the administration of the Plan, subject to all of the provisions of the Plan. The Plan Administrator is empowered, on behalf of the Plan, to engage accountants, legal counsel and such other personnel as it deems necessary or advisable to assist it in the performance of its duties under the Plan. The functions of any such persons engaged by the Plan Administrator will be limited to the specified services and duties for which they are engaged, and such persons will have no other duties, obligations or responsibilities under the Plan. Such persons will exercise no discretionary authority or discretionary control respecting the management of the Plan. All reasonable expenses thereof will be borne by the Company.

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Section 7.02 Withholding Taxes . The Company may withhold from all payments due to the Participant (or his beneficiary or estate) hereunder all taxes which, by applicable federal, state, local or other law, the Company is required to withhold therefrom.
Section 7.03 Scope of Benefits under Plan . Nothing in this Plan shall be deemed to entitle the Participant to continued employment with the Company or its Affiliates; provided, however, that notwithstanding anything herein to the contrary, if the Participant incurs a Qualifying Termination, the Participant shall be subject to all of the benefit and payment provisions of this Plan.
Section 7.04 Successors’ Binding Obligation .
(a) This Plan shall not be terminated by any Company Change or transfer of assets. In the event of any Company Change or transfer of assets, the provisions of this Plan shall be binding upon the surviving or resulting corporation or any person or entity to which the assets of the Company are transferred.
(b) The Company agrees that concurrently with any Company Change or transfer of assets, it will cause any successor or transferee unconditionally to assume by written instrument delivered to the Participant (or his beneficiary or estate) all of the obligations of the Company hereunder.
(c) The rights under this Plan shall inure to the benefit of and be enforceable by the Participant’s personal or legal representatives, executors, administrators, successors, beneficiaries, heirs, distributees, devisees and legatees.
Section 7.05 No Assignment or Transfer; Beneficiaries . Except as otherwise determined by the Plan Administrator, benefits payable under this Plan shall not be assignable or transferable by the Participant, and shall not be subject in any manner to assignment, alienation, pledge, encumbrance or charge. Notwithstanding the foregoing, in the event of the death of a Participant, except as otherwise provided by the Plan Administrator, benefits earned but unpaid under this Plan shall become payable to the Participant’s beneficiary as designated by the Participant in the manner prescribed by the Plan Administrator or, in the absence of an authorized beneficiary designation, by a legatee or legatees of the Participant’s Plan benefit under the Participant’s last will or by such Participant’s executors, personal representatives or distributees of such Plan benefit in accordance with the Participant’s will or the laws of descent and distribution.
Section 7.06 Compensation Recoupment . All awards, amounts or benefits received or outstanding under this Plan shall be subject to clawback, cancellation, recoupment, rescission, payback, reduction or other similar action in accordance with any Company clawback or similar policy or any applicable law related to such actions. Each Participant shall be deemed to have acknowledged and consented to the Company’s application, implementation and enforcement of any applicable Company clawback or similar policy that may apply to the Participant, whether adopted before or after the Effective Date, and any applicable law relating to clawback, cancellation, recoupment, rescission, payback, or reduction of compensation, and the Company may take any actions that may be necessary to effectuate any such policy or applicable law, without further consideration or action.
Section 7.07 Notice .

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(a) For purposes of this Plan, all notices and other communications required or permitted hereunder shall be in writing and shall be deemed to have been duly given when delivered by hand or overnight courier or three (3) days after deposit in the United States mail, registered and return receipt requested, postage prepaid, addressed as follows:
If to the Participant:
To the most recent address of the Participant set forth in the personnel records of the Company
If to the Company:
Syneos Health, Inc.
3201 Beechleaf Court
Raleigh, NC 27604
Attention: Chief Human Resource Officer
or to such other address as either party may have furnished to the other in writing in accordance herewith, except that notices of change of address shall be effective only upon receipt. Alternatively, notice may be deemed to have been delivered when sent by facsimile to a location provided by the other party hereto.
(b) A written notice of the Participant’s Date of Termination by the Company, shall (i) state that the Participant’s employment will be terminated, (ii) state whether the Participant is eligible to receive severance benefits under this Plan; and (iii) specify the Participant’s Date of Termination. In the case of a termination by the Company other than a termination for Cause, the Date of Termination shall not be less than ninety (90) days after the notice of termination is given, unless otherwise agreed to by the Company and Participant. The Company may, in its discretion, relieve the Participant of some or all of his/her duties during all or a part of such notice period. Subject to the forgoing notice obligation, the Participant’s employment with the Company shall remain at will, as applicable law permits.
(c) To allow the Company time to plan for Participant’s departure and for Participant to leave the Company in good standing, Participant must give written notice of his or her voluntary resignation from the Company at least ninety (90) days prior to Participant’s Date of Termination. Participant’s written notice to the Company shall (i) state that Participant is voluntarily resigning his or her employment; (ii) specify the Date of Termination; and (iii) to the extent Participant is claiming to resign for Good Reason, set forth the facts and circumstances claimed to provide a basis for such Good Reason resignation. In the case of a termination by the Participant for Good Reason, the Date of Termination shall be thirty (30) days after the cure period contemplated under Section 1.01(x) has expired if the Company has failed to remedy within such period the circumstances constituting Good Reason, unless otherwise agreed to by the Company. The Company may choose to waive the notice period and accelerate the Date of Termination, but is not obligated to do so. Further, the Company may choose, in its discretion, to relieve the Participant of some or all of his/her duties during all or a part of such notice period. Subject to the forgoing notice obligation, the Participant’s employment with the Company shall remain at will, as applicable law permits.
(d) The failure by the Participant or the Company to set forth in any required notice any fact or circumstance which contributes to a showing of Good Reason or Cause shall not waive any right of the

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Participant or the Company hereunder or preclude the Participant or the Company from asserting such fact or circumstance in enforcing the Participant’s or the Company’s rights hereunder.
Section 7.08 Employment with Affiliates . Employment with the Company for purposes of this Plan shall include employment with any of its Affiliates.
Section 7.9 Governing Law; Validity . The interpretation, construction and performance of the provisions of this Plan shall be governed by and construed and enforced in accordance with the internal laws of the State of North Carolina without regard to the principle of conflicts of laws, to the extent North Carolina laws are not preempted by ERISA. The invalidity or unenforceability of any provision of this Plan shall not affect the validity or enforceability of any other provision of this Plan, which other provisions shall remain in full force and effect.
Section 7.10 Waiver . No provision of this Plan may be waived unless such waiver is agreed to in writing and signed by the Participant and by a duly authorized officer of the Company. No waiver by either party hereto at any time of any breach by the other party hereto of, or compliance with, any condition or provision of this Plan to be performed by such other party shall be deemed a waiver of similar or dissimilar provisions or conditions at the same or at any prior or subsequent time. Failure by the Participant or the Company to insist upon strict compliance with any provision of this Plan or to assert any right the Participant or the Company may have hereunder, including without limitation, the right of the Participant to terminate employment for Good Reason, shall not be deemed to be a waiver of such provision or right or any other provision or right of this Plan.
Section 7.11 Code Section 409A . Notwithstanding any provision of the Plan to the contrary:
(a) General. The Plan and any payments provided hereunder are intended to comply with, or be exempt from, Code Section 409A (“ Section 409A ”). The Plan shall in all respects be interpreted, operated, and administered in accordance with this intent. Payments provided under the Plan may only be made upon an event and in a manner that complies with Section 409A or an applicable exemption, including to the maximum extent possible, exemptions for separation pay due to Separation from Service and/or short-term deferrals. Any payments provided under the Plan to be made upon a Participant’s termination of employment with the Company that constitute deferred compensation subject to Section 409A shall only be made if such termination of service constitutes a Separation from Service. Each installment payment provided under the Plan shall be treated as a separate identified payment for purposes of Section 409A. The Company makes no representations or warranties that the payments provided under the Plan comply with, or are exempt from, Section 409A, and in no event shall the Company be liable for any portion of any taxes, penalties, interest, or other expenses that may be incurred by a Participant on account of non-compliance with Section 409A. If a Participant is a “specified employee” under Section 409A at his or her Date of Termination, any payments to be made upon the Participant’s Separation from Service that constitute deferred compensation subject to Section 409A and that are scheduled to be made within six months following the Participant’s Date of Termination shall be delayed, without interest, and paid in a lump sum on the earlier of (i) the first payroll date to occur following the six (6) month anniversary of the Participant’s Date of Termination, or (ii) the Participant’s death, and any payments otherwise scheduled to be made thereafter shall be made in accordance with their original schedule.

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(b) Change in Control. Any payments provided under the Plan to be made upon a Change in Control that constitute deferred compensation subject to Section 409A shall not be made until the Company undergoes a “change in control event” under Section 409A.
Section 7.12 No Right to Continued Employment . Neither the establishment of the Plan, nor any modification thereof, nor the creation of any fund, trust or account, nor the payment of any benefits will be construed as giving any Participant, or any person whomsoever, the right to be retained in the service of the Company, and all Participants will remain subject to discharge to the same extent as if the Plan had never been adopted.
Section 7.13 Correction of Errors . The Plan Administrator reserves the right to correct any errors that may occur in administering the Plan, including, without limitation, the right to recover any severance benefits paid in excess of those due to Participant because of a mistake or incorrect information about Participant’s entitlement to severance benefits. The Plan Administrator may recover any excess severance benefits by requesting direct payment from Participant, withholding wages or any other monies owed to Participant (if permitted by applicable law), or by using any other appropriate legal means.
Section 7.14 Termination of Severance Benefits . Severance benefits will end in the event (i) Participant receives all severance benefits to which he or she is entitled under the Plan; (ii) Participant is rehired by the Company; (iii) Participant violates the Release or any confidentiality, non-competition, or non-solicitation agreement, or similar restrictive covenant with the Company; (iv) Participant violates any Post-Employment Restrictive Covenants and Other Obligations he or she has agreed to with the Company; (v) Participant engages in any activity that the Plan Administrator determines is harmful to the Company; or (vi) the Plan is terminated.
ARTICLE VIII
CLAIMS, INQUIRIES, APPEALS
Section 8.01 Applications for Benefits and Inquiries . Any application for benefits, inquiries about the Plan or inquiries about present or future rights under the Plan must be submitted to the claims administrator in writing, as follows:
Claims Administrator
Syneos Health, Inc.
3201 Beechleaf Court
Raleigh, NC 27604
Section 8.02 Denial of Claims . In the event that any application for benefits is denied in whole or in part, the claims administrator must notify the applicant, in writing, of the denial of the application, and of the applicant’s right to review the denial. The written notice of denial will be set forth in a manner designed to be understood by the Participant, and will include specific reasons for the denial, specific references to the Plan provision upon which the denial is based, a description of any information or material that the claims administrator needs to complete the review and an explanation of the Plan’s review procedure.
This written notice will be given to the Participant within thirty (30) days after the claims administrator receives the application, unless special circumstances require an extension of time, in which

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case, the claims administrator has up to an additional thirty (30) days for processing the application. If an extension of time for processing is required, written notice of the extension will be furnished to the applicant before the end of the initial thirty (30) day period.
This notice of extension will describe the special circumstances necessitating the additional time and the date by which the claims administrator is to render his or her decision on the application. If written notice of denial of the application for benefits is not furnished within the specified time, the application will be deemed to be denied. The applicant will then be permitted to appeal the denial in accordance with the review procedure described below.
Section 8.03 Request for a Review . Any person (or that person’s authorized representative) for whom an application for benefits is denied (or deemed denied), in whole or in part, may (but without any obligation to do so) appeal the denial by submitting a request for a review to the Plan Administrator within sixty (60) days after the application is denied (or deemed denied). The Plan Administrator will give the applicant (or his or her representative) an opportunity to review pertinent documents in preparing a request for a review and submit written comments, documents, records and other information relating to the claim. A request for a review will be in writing and will be addressed to:
Claims Administrator
Syneos Health, Inc.
3201 Beechleaf Court
Raleigh, NC 27604
A request for review must set forth all of the grounds on which it is based, all facts in support of the request and any other matters that the applicant feels are pertinent. The Plan Administrator may require the applicant to submit additional facts, documents or other material as he or she may find necessary or appropriate in making his or her review.
Section 8.04 Decision on Review . The Plan Administrator will act on each request for review within twenty (20) days after receipt of the request, unless special circumstances require an extension of time (not to exceed an additional twenty (20) days), for processing the request for a review. If an extension for review is required, written notice of the extension will be furnished to the applicant within the initial twenty (20) day period. The Plan Administrator will give prompt, written notice of his or her decision to the applicant. In the event that the Plan Administrator confirms the denial of the application for benefits in whole or in part, the notice will outline, in a manner calculated to be understood by the applicant, the specific Plan provisions upon which the decision is based. If written notice of the Plan Administrator’s decision is not given to the applicant within the time prescribed in this Section 8.04 the application will be deemed denied on review.
Section 8.05 Rules and Procedures . The Plan Administrator may establish rules and procedures, consistent with the Plan and with ERISA, as necessary and appropriate in carrying out his or her responsibilities in reviewing benefit claims. The Plan Administrator may require an applicant who wishes to submit additional information in connection with an appeal from the denial (or deemed denial) of benefits to do so at the applicant’s own expense.

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Section 8.06 Exhaustion of Remedies . No claim for benefits under the Plan may be brought in any forum until the claimant (a) has submitted a written application for benefits in accordance with the procedures described by Section 8.01 above, (b) has been notified by the claims administrator that the application is denied (or the application is deemed denied due to the claims administrator’s failure to act on it within the established time period), (c) has filed a written request for a review of the application in accordance with the appeal procedure described in Section 8.03 above and (d) has been notified in writing that the Plan Administrator has denied the appeal (or the appeal is deemed to be denied due to the Plan Administrator’s failure to take any action on the claim within the time prescribed by Section 8.04 above).
Section 8.07 Final Dispute Resolution; Limitations on Legal Action . Any and all claims and disputes under this Plan (including but not limited to claims and disputes regarding interpretation, scope, or validity of the Plan, and any pendant state claims if not otherwise preempted by ERISA) must follow the claims procedures described in Sections 8.01 through 8.06 above, before a claimant may take action in any other forum regarding a claim for benefits under the Plan. Furthermore, any action initiated by a claimant under the Plan must be brought within one (1) year of a final determination on the claim for benefits under these claims procedures or the claimant’s benefit claim will be deemed permanently waived and abandoned and the claimant will be precluded from reasserting it. Further, after following the claims procedures described in Sections 8.01 through 8.06 above, the following provisions apply to any further disputes, claims, questions or disagreements that may arise regarding this Plan:
(a) In the event of any such further dispute, claim, question or disagreement arising out of or relating to this Plan, the parties shall use their best efforts to settle such dispute, claim, question or disagreement. To this effect, they shall consult and negotiate with each other, in good faith, and, recognizing their mutual interests, attempt to reach a just and equitable resolution satisfactory to both parties.

(b) If the parties do not reach a resolution within a period of thirty (30) days, then such unresolved dispute, claim, question or disagreement, upon notice by any party to the other, shall be submitted to and finally settled by arbitration in accordance with the Commercial Arbitration Rules (the “Rules”) of the American Arbitration Association (“AAA”) in effect at the time demand for arbitration is made by any such party. The parties shall mutually agree upon a single arbitrator within thirty (30) days of such demand. In the event that the parties are unable to so agree within such thirty (30) day period, then within the following thirty (30) day period, one arbitrator shall be named by each party. A third arbitrator shall be named by the two arbitrators so chosen within ten (10) days after the appointment of the first two arbitrators. In the event the third arbitrator is not agreed upon, he or she shall be named by the AAA. Arbitration shall occur in the State of North Carolina or such other location as may be mutually agreed by the parties.

(c) All awards made by all or a majority of the arbitrators shall be final and binding, and judgment may be entered based upon such award in any court of law having competent jurisdiction. Any such award is subject to confirmation, modification, correction or vacation only as explicitly provided in Title 9 of the United States Code. The parties acknowledge that this Plan evidences a transaction involving interstate commerce. The United States Arbitration Act and the Rules shall govern the interpretation, enforcement and proceedings pursuant to this Section 8.07. Any provisional remedy which would be available from a court of law shall be available from the arbitrators to the parties to this Plan pending arbitration. Either party may make an application to the arbitrators seeking injunctive relief to maintain the status quo, or may seek from

15


a court of competent jurisdiction any interim or provisional relief that may be necessary to protect the rights and property of that party, until such times as the arbitration award is rendered or the controversy otherwise resolved.

(d) To the full extent permitted by law and upon presentation of appropriate documentation, all reasonable legal fees and expenses incurred by a Participant as a result of any dispute under this Section 8.07 involving the validity or enforceability of, or liability under, any provision of this Plan (including as a result of any dispute involving the amount of any payment or other benefit due pursuant to this Plan) shall be paid by the Company if the arbitrator determines that the Company unreasonably or maliciously contested the validity or enforceability of any provision of this Plan.

(e) By agreeing to binding arbitration, a Participant must waive his or her right to a jury trial. The claims covered by this Section 8.07 include any statutory claims regarding a Participant’s employment or the termination of his or her employment, including without limitation, claims regarding workplace discrimination.
Section 8.08 Attorneys’ Fees . In the event of any dispute under this Plan, the arbitrator(s) or court may award attorneys’ fees as provided under 29 U.S.C. 1132(g)(1).

THIS EXECUTIVE SEVERANCE PLAN was approved by the Compensation Committee of the Board of Directors of Syneos Health, Inc. on August 20, 2018, to be effective as of such date.
SYNEOS HEALTH, INC.













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EXHIBIT A
GENERAL RELEASE AGREEMENT
This General Release Agreement (the “Agreement”) is made and entered into by ___________________ (“Employee” or “Your” or “Your”) and Your spouse, attorneys, heirs, dependents, beneficiaries, executors, administrators, successors, and assigns (collectively, referred to in this Agreement as “ Employee ”) and Syneos Health, Inc. , any parent, subsidiary, affiliate, successor, predecessor or otherwise related companies, and the past, present, and future employees, agents, officers, attorneys, directors, shareholders, members, managers and executive benefit programs of any of them, and their agents and insurers (collectively, referred to in this Agreement as “ Syneos Health ” or the “ Company ”). This Agreement shall become effective upon the signing of this Agreement by You or, if applicable, as defined in Section 9.2 below.
In consideration of the severance pay and benefits (“Severance Benefits”) provided to Employee as set forth in the Syneos Health, Inc.’s Executive Severance Plan (the “Severance Plan”), as well as any promises set forth in this Agreement, Executive agrees as follows:
1.     Release of Claims .
1.1    In exchange for the Company providing You with the payments and other benefits set forth in the Severance Plan, to the fullest extent allowed by applicable law, You, individually and on behalf of Your heirs, executors, personal representatives, administrators, agents and assigns, forever waive, release, give up and discharge all waivable claims, liabilities and other causes of action, real or perceived, whether now known or unknown, against the Company, its parent, subsidiaries, affiliates, and other related and affiliated companies, their employee benefit plans and trustees, fiduciaries, administrators, sponsors and parties-in-interest of those plans, and all of their past and present employees, managers, directors, officers, administrators, shareholders, members, agents, attorneys, insurers, re-insurers and contractors acting in any capacity whatsoever, and all of their respective predecessors, heirs, personal representatives, successors and assigns (collectively, the “Released Parties” as used throughout this Agreement), which have arisen, occurred or existed at any time prior to the date of this Agreement (or which You may have in the future as a result of acts that occurred prior to the date You sign this Agreement), including, without limitation, any and all claims, liabilities and causes of action arising out of, relating to, or in connection with Your employment with the Company, any terms, conditions or privileges related to Your employment with the Company, the termination of Your employment by the Company, the payment or non-payment of Your salary, bonuses or equity compensation or other incentive compensation by the Company, claims of wrongful discharge, retaliation, defamation, hostile environment, discrimination, personal injury, physical injury, misrepresentation or emotional distress, any change in control of the Company, and all alleged violations of federal, state or local fair employment practices or laws by any of the Released Parties for any reason and under any legal theory including, but not limited to, Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000(e), et seq., the Americans with Disabilities Act, 42 U.S.C. § 12101, et seq., the Age Discrimination in Employment Act, 29 U.S.C. § 621, et seq., the Older Worker Benefits Protection Act, 29 U.S.C. § 626(f), et seq., the Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1001, et seq., the Civil Rights Act of 1991, 42 U.S.C. §§ 1981, 1983, 1985, 1986 and 1988, the Family and Medical Leave Act, 29 U.S.C. § 2601, et seq., the Fair Labor Standards Act, 29 U.S.C. § 215(a)(3), et seq., the Equal Pay Act of 1963, 29 U.S.C. § 206, et seq., the Lilly Ledbetter Fair Pay Act of 2009, H.R. 11, the Consolidated Omnibus Budget Reconciliation Act, 29 U.S.C. § 1161, et seq. (“COBRA”), the Occupational Safety and Health Act, 29 U.S.C. 651 et seq., and all other federal or state or local laws, regulations, rules, ordinances, or orders prohibiting employment discrimination or regulating employment or termination of employment, as they may be amended. Without limiting the generality of the foregoing, You also forever waive, release, discharge and give up all claims, real or perceived and now known or unknown, for breach of implied or express contract, including but not limited to breach of promise, breach of the covenant of good faith and fair dealing, misrepresentation, negligence, fraud, estoppel, defamation, libel, misrepresentation,

17


intentional infliction of emotional distress, violation of public policy, wrongful, retaliatory or constructive discharge, assault, battery, false imprisonment, negligence, and all other claims or torts arising under any federal, state, or local law, regulation, ordinance or judicial decision, or under the United States or any state Constitutions. This waiver and release is of Your rights to all remedies and damages available to You in law or equity, including but not limited to Your right to compensation, backpay, front pay, non-economic damages, punitive and exemplary damages, statutory damages, attorneys’ fees, injunctive relief and declaratory judgments. Nothing in this Agreement shall be construed to release any claims or waive any substantive rights that cannot be released or waived as a matter of applicable law. This general release does not extend to claims which You do not know or suspect exist at the time of executing the release, which if known by You would have materially affected Your entering into this Agreement with the Company.
1.2    Notwithstanding the release contained in Section 1.1 above, You do not waive (i) Your entitlement to receive any 401(k), pension plan benefits, or Company ERISA-covered benefits that shall have vested (if any) as of the date You sign this Agreement to the extent You have any entitlement to those benefits under the terms of the relevant plans, or (ii) Your right to file a charge with the EEOC or participate in an investigation conducted by the EEOC; however, You expressly waive Your right to monetary or other relief should any administrative agency, including but not limited to the EEOC, pursue any claim on Your behalf.
1.3    The release contained in Section 1.1 above does not apply to any claim or rights that may arise after that date You sign this Agreement or claims that the controlling law clearly states may not be released by private agreement. You also understand that You are not waiving Your rights to unemployment compensation.
2.0     Covenant Not to Sue .
2.1    You warrant that You do not have any complaint, charge or grievance against any Released Party pending before any federal, state or local court or administrative or arbitral agency, and You further agree and covenant not to sue, file a lawsuit, or commence any other proceeding, arbitral, administrative or judicial action, against any of the Released Parties in any court of law or equity, or before any arbitral body or administrative agency, with respect to any matter released in Section 1.1 above; provided, however, that this covenant not to sue does not affect Your rights to enforce appropriately the terms of the Severance Plan in a court of competent jurisdiction and does not affect Your right to file a charge with the EEOC or participate in an investigation conducted by the EEOC; however, You expressly waive Your right to monetary or other relief should any administrative agency, including but not limited to the EEOC, pursue any claim on Your behalf. Notwithstanding the foregoing, nothing herein shall limit Your right to receive an award for information provided to the Securities and Exchange Commission.
Nothing in this Agreement prohibits You from reporting possible violations of federal law or regulation to any governmental agency or entity, including but not limited to the Department of Justice, the Securities and Exchange Commission, the Congress, and any agency Inspector General, or making other disclosures that are protected under the whistleblower provisions of federal law or regulation. You do not need the prior authorization of the Company to make any such reports or disclosures and You are not required to notify the Company that You have made such reports or disclosures.
2.2    Should You file a lawsuit with any court concerning any claim, demand, issue, or cause of action waived, released or discharged through this Agreement or otherwise in breach of Section 2.1 above, You agree (i) that any amounts payable or paid to You, as applicable, pursuant to Section 2 of the Severance Plan shall no longer be payable and, if already paid, shall promptly be returned to the Company and (ii) to the fullest extent allowed by applicable law, to indemnify the Released Parties for all costs and expenses incurred by them in defending such lawsuit. You further agree that nothing in this Agreement shall limit the right of a court to determine, in its sole discretion, that the Released Parties are entitled to restitution, recoupment or set

18


off of any monies paid should the release of any claims under this Agreement subsequently be found to be invalid.
2.3     You agree not to advocate or incite the institution of, or assist or participate in, any suit, unrest, complaint, charge or administrative proceeding by any other person against any of the Released Parties, unless compelled by legal process to do so. Nothing in this Section 2 shall prohibit any Party from lawfully participating or cooperating in an investigative proceeding of any federal, state or local government agency.
3.0     Non-Admission of Liability . You agree that this Agreement shall not in any way be construed as an admission that any of the Released Parties owe You any money or have acted wrongfully, unlawfully, or unfairly in any way towards You. In fact, You understand that the Released Parties specifically deny that they have violated any federal, state or local law or ordinance or any right or obligation that they owe or might have owed to You at any time, and maintain that they have at all times treated You in a fair, non-discriminatory and non-retaliatory manner.
4.0     Confidentiality of Agreement; Non-Disparagement . You also acknowledge and agree that You shall not publicize, communicate, authorize or permit the publication or communication in any form whatsoever of the contents of the Agreement or the events giving rise thereto, except to Your immediate family, Your financial advisors and/or legal counsel, or where required by law. Further, You undertake and agree that You shall not defame, disparage or otherwise speak negatively about the Company, Your employment at the Company or the circumstances surrounding Your termination.
5.0      Confidentiality of the Company’s Confidential Information . You acknowledge that due to the position that You occupied and the responsibilities that You held at the Company, You may have received Confidential Information concerning the Company’s products, computer processes, data systems, employment policies, procedures, customers, sales, client lists, prices, personnel, employee relations, internal documents and programs, contracts, and the like. You hereby promise and agree that, unless compelled by legal process, You will not disclose to others and will keep confidential all information You have received while employed by the Company or any entity of which the Company has acquired its assets, concerning products, processes, and procedures, internal capabilities, the identities of customers, sales, prices, personnel, the terms of any contracts with third parties, and any and all proprietary information. You agree that a violation by You of the foregoing obligation to maintain the confidentiality of the Company’s Confidential Information will constitute a material breach of this Agreement.
You further agree that all materials, computer and telephone equipment, documents, information, programs, and suggestions provided for the Company by You in connection with Your employment shall be the exclusive property of the Company or its designee. All information contained in any computer databases generated by You in connection with Your employment shall be the property of the Company or its designee, and the Company may use the data in any way it deems appropriate. Any copyrightable work created by You on behalf of the Company shall be considered work made for hire, whether published or unpublished, and all rights therein shall be the property of the Company as author and owner of copyright in such particular work. Notwithstanding the above, the Company acknowledges that You may possess and reserve Your rights in certain inventions, know-how, and improvements that can be clearly substantiated to have been entirely independently developed by You and can be shown to be unrelated to the Company and Your performance for the Company.
6.0      Obligation to Cooperate and Assist . You agree to cooperate in good faith with the Company to assist it with any information or matter which is within Your knowledge as a result of Your employment with the Company, including but not limited to making Yourself reasonably available for interview by the Company’s

19


attorneys, or providing truthful testimony without the necessity of a subpoena or compensation, in any pending or future legal matter in which the Company is a party.
7.0      Representations and Indemnification .
7.1     You represent and affirm that You will abide by any and all post-employment restrictive covenants You signed or entered into in connection with Your employment, including but not limited to, covenants relating to competition, solicitation or hiring of employees, solicitation of customers, and confidentiality.
7.2     You agree that You will indemnify and hold the Released Parties from any loss, cost, damage or expense (including attorneys’ fees) incurred by the Released Parties arising out of Your breach of any portion of this Agreement or any post-employment restrictive covenant You signed or entered into in connection with Your employment. You also agree and understand that Your entitlement to and retention of the Severance Benefits the Company has agreed to provide to You are expressly conditioned upon Your fulfillment of Your promises herein and any applicable post-employment restrictive covenants, and You agree that if You breach this Agreement or any applicable post-employment restrictive covenants that any amounts payable or paid to You, as applicable, pursuant to the Severance Plan, shall no longer be payable and, if already paid, shall promptly be returned to the Company within seven (7) days of the Company providing you with written notice of Your breach of any provision of this Agreement or any applicable post-employment restrictive covenants, to the extent permitted or required by law. The Company shall determine whether a breach has occurred in its sole discretion and under any applicable law or regulation.
8.0      Miscellaneous.
8.1     Governing Law and Venue . This agreement and its negotiation, execution, performance or non-performance, interpretation, termination, construction and all claims or causes of action (whether in contract or tort) including resolutions of disputes that may be based upon, arise out of or relate to this agreement, or the negotiation and performance of this agreement (including any claim or cause of action based upon, arising out of or related to any representation or warranty made or in connection with this agreement or as an inducement to enter into this agreement) (each a “proceeding”) shall be governed by, and construed in accordance with, the laws of the State of North Carolina, regardless of laws that might otherwise govern under any applicable conflict of laws principles. Any action relating to this agreement shall be instituted and prosecuted only in the courts of Wake County, North Carolina or the federal courts of the Eastern District of North Carolina, and the Company and Employee hereby consent to the jurisdiction of such courts and waive any right or defense relating to venue and jurisdiction over the person. The language of all parts of this agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties, by virtue of the identity, interest, or affiliation of its preparer.
8.2     Severability . Whenever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable law, but if any provision of this Agreement shall be prohibited by or invalid under such law, such provision shall be ineffective to the extent of such prohibition or invalidity and severed from this Agreement, without invalidating the remainder of such provision or remaining provisions of this Agreement.
8.3     Proper Construction . The language of this Agreement shall be construed within the context of the whole Agreement and according to its fair meaning, and not strictly for or against any of the Parties. The section headings used in this Agreement are intended solely for convenience of reference and shall not in any manner amplify, limit, modify or otherwise be used in the interpretation of any of the provisions hereof.
8.4     Survival . You acknowledge that the covenants set forth in the Severance Plan and any provisions contained in the Severance Plan that are intended to survive following termination of Your employment shall,

20


pursuant to their terms, survive the execution of this Agreement by You. You further acknowledge that any and all post-employment restrictive covenants You signed in connection with Your employment, including covenants relating to competition, solicitation or hiring and non-disclosure agreements remain in full force and effect in accordance with their terms and a breach of those covenants or agreements will also constitute a breach of this present Agreement.
8.5     Amendments . This Agreement may be modified, altered or terminated only by an express written agreement between You and the Company, which agreement must be signed by all Parties or their duly authorized agents, and expressly reference and attach a copy of this Agreement to be effective.
8.6     Counterparts . This Agreement may be signed in counterparts and said counterparts shall be treated as though signed as one document. In the event that the Parties execute this Agreement by exchange of portable document format or other electronically signed copies or facsimile signed copies, the Parties agree that, upon being signed by all the Parties, this Agreement shall become effective and binding and that such copies shall constitute evidence of the existence of this Agreement.
8.7      No Reliance on Representations . You represent and acknowledge that in executing this Agreement that You do not rely and have not relied upon any representation or statement made by any of the Released Parties or by any of the Released Parties’ agents, representatives, or attorneys with regard to the subject matter, basis, or effect of this Agreement or otherwise.
8.8      Medicare Representations . You affirm, covenant, and warrant that You are not a Medicare beneficiary and are not currently receiving, have not received in the past, will not have received at the time of payment pursuant to this Agreement, are not entitled to, are not eligible for, and have not applied for or sought Social Security Disability or Medicare benefits. In the event any statement in the preceding sentence is incorrect (for example, but not limited to, if You are a Medicare beneficiary, etc.), the following sentences (i.e., the remaining sentences of this paragraph) apply. You affirm, covenant, and warrant that You have made no claim for illness or injury against, nor are You aware of any facts supporting any claim against, the Released Parties under which the Released Parties could be liable for medical expenses incurred by You before or after the execution of this Agreement. Furthermore, You are aware of no medical expenses that Medicare has paid and for which the Released Parties are or could be liable now or in the future. You agree and affirm that, to the best of Your knowledge, no liens of any governmental entities, including those for Medicare conditional payments, exist. You will indemnify, defend, and hold the Released Parties harmless from Medicare claims, liens, damages, conditional payments, and rights to payment, if any, including attorneys’ fees, and You further agrees to waive any and all future private causes of action for damages pursuant to 42 U.S.C. § 1395y(b)(3)(A), et seq.
9.0     Acknowledgment .
9.1    You confirm that, to the best of Your knowledge, You have returned to the Company all of its property, including without limitation, computer equipment, software, keys and access cards, credit cards, files and any documents (including computerized data and any copies made of any computerized data or software) containing information concerning the Company, its business or its business relationships. You also commit to deleting and finally purging any duplicates of files or documents that may contain the Company information from any computer or other device that remains Your property after the Termination Date, provided such information is not subject to an ongoing litigation hold.
9.2     You acknowledge that if you are age 40 or over, that You have had twenty-one (21) days, or if required for an effective release, forty-five (45) days, after receipt of this agreement to consider whether to execute this agreement and that you understand all the provisions of this agreement. You also understand that after you execute this Agreement, you have seven (7) days to revoke the portion of this Agreement that relates

21


to waiver and release of any claim you might assert under the Age Discrimination in Employment Act (“ADEA”). The parties agree that no payment as set forth in the Severance Plan will be made until after the seven (7) day revocation period has expired (the eighth day after You execute this Agreement being the “Effective Date” of this Agreement for those age 40 or over). You understand that by signing this Agreement, You are not waiving or releasing any ADEA claims based on actions or omissions that occur after the date of Employee’s signing of this Agreement. You agree that any revocation of Your ADEA waiver and release must be made in writing and postmarked on or before the seventh day following the execution of this Agreement and sent by certified mail to the respective company contact at the addresses set forth in Section 9.2.
9.4    You acknowledge that with the exception of any payments and other benefits set forth in the Severance Plan or any signed retention bonus agreement (if applicable), and of your final paycheck (to include Your regular wages and any accrued by unused vacation or other paid time off to be delivered by the next regularly scheduled payday or otherwise as required by law), You acknowledge payment of all compensation due to You by the Company.    
9.6    You acknowledge that You have been advised in writing, as reflected in this agreement, and hereby are advised, to seek legal counsel concerning the terms of this agreement. You warrant that you have read this agreement, are knowingly and voluntarily entering into it and intend to be legally bound by the same, and that your agreement thereto has not been the result of coercion or duress by the company. You certify and agree that you are authorized and competent to sign this agreement, and that you are receiving valuable and adequate consideration under this Agreement.
BY YOUR SIGNATURE BELOW, YOU ACKNOWLEGE THAT (1) YOU HAVE CAREFULLY READ AND CONSIDERED THIS AGREEMENT; (2) HAVE BEEN GIVEN SUFFICIENT TIME TO CONSIDER WHETHER TO SIGN THIS AGREEMENT; (3) RECOGNIZE AND UNDERSTAND THAT THIS AGREEMENT CONTAINS A FULL AND FINAL RELEASE BY YOU OF ALL CLAIMS OF EVERY KIND AGAINST THE COMPANY ARISING UP TO THE TIME YOU SIGN THIS AGREEMENT, WHETHER YOU CURRENTLY KNOW OR SUSPECT THOSE CLAIMS TO EXIST; AND (4) KNOWINGLY AND VOLUNTARILY CONSENT TO THE TERMS OF THIS AGREEMENT WITH FULL UNDERSTANDING OF THEIR MEANING.
IN WITNESS WHEREOF, Employee has executed this General Release Agreement as of the date set forth below.

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EMPLOYEE


_________________________________

Dated: ___________________________





Received, Acknowledged and Accepted:

SYNEOS HEALTH, INC.


By: ______________________________
General Counsel

Date: _____________________________



23
Exhibit 10.2
 


SECOND AMENDMENT TO THE
RECEIVABLES FINANCING AGREEMENT

This SECOND AMENDMENT TO THE RECEIVABLES FINANCING AGREEMENT (this “ Amendment ”), dated as of August 29, 2018, is entered into by and among the following parties:
(i)
SYNEOS HEALTH RECEIVABLES LLC, as Borrower;
(ii)
INC RESEARCH, LLC, as initial Servicer; and
(iii)
PNC BANK, NATIONAL ASSOCIATION (“ PNC ”), as Administrative Agent and as Lender.
Capitalized terms used but not otherwise defined herein (including such terms used above) have the respective meanings assigned thereto in the Receivables Financing Agreement described below.
BACKGROUND
A.    The parties hereto have entered into a Receivables Financing Agreement, dated as of June 29, 2018 (as amended, restated, supplemented or otherwise modified through the date hereof, the “ Receivables Financing Agreement ”).
B.    The parties hereto desire to amend the Receivables Financing Agreement as set forth herein.
NOW, THEREFORE, with the intention of being legally bound hereby, and in consideration of the mutual undertakings expressed herein, each party to this Amendment hereby agrees as follows:
SECTION 1.      Amendment to the Receivables Financing Agreement . Schedule II to the Receivables Financing Agreement is hereby replaced in its entirety with Schedule II hereto.
SECTION 2.      Representations and Warranties of the Borrower and Servicer . The Borrower and the Servicer hereby represent and warrant to each of the parties hereto as of the date hereof as follows:
(a)      Representations and Warranties . The representations and warranties made by it in the Receivables Financing Agreement and each of the other Transaction Documents to which it is a party are true and correct as of the date hereof.
(b)      Enforceability . The execution and delivery by it of this Amendment, and the performance of its obligations under this Amendment, the Receivables Financing Agreement (as amended hereby) and the other Transaction Documents to which it is a party are within its organizational powers and have been duly authorized by all necessary action on its part, and this Amendment, the Receivables Financing Agreement (as amended hereby) and the other Transaction Documents to which it is a party are (assuming due authorization and

1



execution by the other parties thereto) its valid and legally binding obligations, enforceable in accordance with their terms, except (i) as such enforceability may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors’ rights generally and (ii) as such enforceability may be limited by general principles of equity, regardless of whether such enforceability is considered in a proceeding in equity or at law.
(c)      No Event of Default . No Event of Default or Unmatured Event of Default has occurred and is continuing, or would occur as a result of this Amendment or the transactions contemplated hereby.
SECTION 3.      Effect of Amendment; Ratification . All provisions of the Receivables Financing Agreement and the other Transaction Documents, as expressly amended and modified by this Amendment, shall remain in full force and effect. After this Amendment becomes effective, all references in the Receivables Financing Agreement (or in any other Transaction Document) to “this Receivables Financing Agreement”, “this Agreement”, “hereof”, “herein” or words of similar effect referring to the Receivables Financing Agreement shall be deemed to be references to the Receivables Financing Agreement as amended by this Amendment. This Amendment shall not be deemed, either expressly or impliedly, to waive, amend or supplement any provision of the Receivables Financing Agreement other than as set forth herein. The Receivables Financing Agreement, as amended by this Amendment, is hereby ratified and confirmed in all respects.
SECTION 4.      Effectiveness . This Amendment shall become effective as of the date hereof upon the Administrative Agent’s receipt of counterparts to this Amendment executed by each of the parties hereto.
SECTION 5.      Severability . Any provisions of this Amendment which are prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction.
SECTION 6.      Transaction Document . This Amendment shall be a Transaction Document for purposes of the Receivables Financing Agreement.
SECTION 7.      Counterparts . This Amendment may be executed in any number of counterparts, each of which when so executed shall be deemed to be an original and all of which when taken together shall constitute one and the same agreement. Delivery of an executed counterpart hereof by facsimile or other electronic means shall be equally effective as delivery of an originally executed counterpart.

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SECTION 8.      GOVERNING LAW AND JURISDICTION .
(a)      THIS AMENDMENT, INCLUDING THE RIGHTS AND DUTIES OF THE PARTIES HERETO, SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK (INCLUDING SECTIONS 5-1401 AND 5-1402 OF THE GENERAL OBLIGATIONS LAW OF THE STATE OF NEW YORK, BUT WITHOUT REGARD TO ANY OTHER CONFLICTS OF LAW PROVISIONS THEREOF).
(b)      EACH PARTY HERETO HEREBY IRREVOCABLY SUBMITS TO (I) WITH RESPECT TO THE BORROWER AND THE SERVICER, THE EXCLUSIVE JURISDICTION, AND (II) WITH RESPECT TO EACH OF THE OTHER PARTIES HERETO, THE NON-EXCLUSIVE JURISDICTION, IN EACH CASE, OF ANY NEW YORK STATE OR FEDERAL COURT SITTING IN NEW YORK CITY, NEW YORK IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS AMENDMENT, AND EACH PARTY HERETO HEREBY IRREVOCABLY AGREES THAT ALL CLAIMS IN RESPECT OF SUCH ACTION OR PROCEEDING (I) IF BROUGHT BY THE BORROWER, THE SERVICER OR ANY AFFILIATE THEREOF, SHALL BE HEARD AND DETERMINED, AND (II) IF BROUGHT BY ANY OTHER PARTY TO THIS AMENDMENT, MAY BE HEARD AND DETERMINED, IN EACH CASE, IN SUCH NEW YORK STATE COURT OR, TO THE EXTENT PERMITTED BY LAW, IN SUCH FEDERAL COURT. NOTHING IN THIS SECTION 8 SHALL AFFECT THE RIGHT OF THE ADMINISTRATIVE AGENT OR ANY OTHER CREDIT PARTY TO BRING ANY ACTION OR PROCEEDING AGAINST THE BORROWER OR THE SERVICER OR ANY OF THEIR RESPECTIVE PROPERTY IN THE COURTS OF OTHER JURISDICTIONS. EACH OF THE BORROWER AND THE SERVICER HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT IT MAY EFFECTIVELY DO SO, THE DEFENSE OF AN INCONVENIENT FORUM TO THE MAINTENANCE OF SUCH ACTION OR PROCEEDING. THE PARTIES HERETO AGREE THAT A FINAL JUDGMENT IN ANY SUCH ACTION OR PROCEEDING SHALL BE CONCLUSIVE AND MAY BE ENFORCED IN OTHER JURISDICTIONS BY SUIT ON THE JUDGMENT OR IN ANY OTHER MANNER PROVIDED BY LAW.
SECTION 9.      Section Headings . The various headings of this Amendment are included for convenience only and shall not affect the meaning or interpretation of this Amendment, the Receivables Financing Agreement or any provision hereof or thereof.
[SIGNATURE PAGES FOLLOW]


3



IN WITNESS WHEREOF, the parties hereto have executed this Amendment by their duly authorized officers as of the date first above written.

 
SYNEOS HEALTH RECEIVABLES LLC  
 
By:
/s/ Thomas E. Zajkowski  
Name: Thomas E. Zajkowski
Title: President
 
 
 
 
 


 
INC RESEARCH, LLC,
as the Servicer  

 
By:
/s/ Jason Meggs  
Name: Jason Meggs
Title: Chief Financial Officer
 
 
 
 
 
 
 
 


S-1





 
PNC BANK, NATIONAL ASSOCIATION,
as Administrative Agent
 

 
By:
/s/ Christopher Blaney  
Name: Christopher Blaney
Title: Senior Vice President



 
 
 
 
 
PNC BANK, NATIONAL ASSOCIATION,
as a Lender
 


By: /s/ Christopher Blaney  
Name: Christopher Blaney
Title: Senior Vice President

 
 
 
 
 
 
 
 
 
 
 
 
 



S-2




SCHEDULE II
Lock-Boxes, Collection Accounts and Collection Account Banks

Collection Account Bank
Collection Account Number
Associated Lock-Box (if any)
Bank of America, N.A.
-
-
Wells Fargo Bank, National Association
-
N/A
Wells Fargo Bank, National Association
-
N/A



Exhibit 10.3
 


THIRD AMENDMENT TO THE
RECEIVABLES FINANCING AGREEMENT

This THIRD AMENDMENT TO THE RECEIVABLES FINANCING AGREEMENT (this “ Amendment ”), dated as of October 25, 2018, is entered into by and among the following parties:
(i)
SYNEOS HEALTH RECEIVABLES LLC, as Borrower;
(ii)
INC RESEARCH, LLC, as initial Servicer; and
(iii)
PNC BANK, NATIONAL ASSOCIATION (“ PNC ”), as Administrative Agent and as Lender.
Capitalized terms used but not otherwise defined herein (including such terms used above) have the respective meanings assigned thereto in the Receivables Financing Agreement described below.
BACKGROUND
A.    The parties hereto have entered into a Receivables Financing Agreement, dated as of June 29, 2018 (as amended, restated, supplemented or otherwise modified through the date hereof, the “ Receivables Financing Agreement ”).
B.    The parties hereto desire to amend the Receivables Financing Agreement as set forth herein.
NOW, THEREFORE, with the intention of being legally bound hereby, and in consideration of the mutual undertakings expressed herein, each party to this Amendment hereby agrees as follows:
SECTION 1.      Amendments to the Receivables Financing Agreement . The Receivables Financing Agreement is hereby amended to incorporate the changes shown on the marked pages of the Receivables Financing Agreement attached hereto as Exhibit A .
SECTION 2.      Representations and Warranties of the Borrower and Servicer . The Borrower and the Servicer hereby represent and warrant to each of the parties hereto as of the date hereof as follows:
(a)      Representations and Warranties . The representations and warranties made by it in the Receivables Financing Agreement and each of the other Transaction Documents to which it is a party are true and correct as of the date hereof.
(b)      Enforceability . The execution and delivery by it of this Amendment, and the performance of its obligations under this Amendment, the Receivables Financing Agreement (as amended hereby) and the other Transaction Documents to which it is a party are within its organizational powers and have been duly authorized by all necessary action on its part, and this Amendment, the Receivables Financing Agreement (as amended hereby) and the other Transaction Documents to which it is a party are (assuming due authorization and

1



execution by the other parties thereto) its valid and legally binding obligations, enforceable in accordance with their terms, except (i) as such enforceability may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors’ rights generally and (ii) as such enforceability may be limited by general principles of equity, regardless of whether such enforceability is considered in a proceeding in equity or at law.
(c)      No Event of Default . No Event of Default or Unmatured Event of Default has occurred and is continuing, or would occur as a result of this Amendment or the transactions contemplated hereby.
SECTION 3.      Effect of Amendment; Ratification . All provisions of the Receivables Financing Agreement and the other Transaction Documents, as expressly amended and modified by this Amendment, shall remain in full force and effect. After this Amendment becomes effective, all references in the Receivables Financing Agreement (or in any other Transaction Document) to “this Receivables Financing Agreement”, “this Agreement”, “hereof”, “herein” or words of similar effect referring to the Receivables Financing Agreement shall be deemed to be references to the Receivables Financing Agreement as amended by this Amendment. This Amendment shall not be deemed, either expressly or impliedly, to waive, amend or supplement any provision of the Receivables Financing Agreement other than as set forth herein. The Receivables Financing Agreement, as amended by this Amendment, is hereby ratified and confirmed in all respects.
SECTION 4.      Effectiveness . This Amendment shall become effective as of the date hereof upon the Administrative Agent’s receipt of counterparts to this Amendment executed by each of the parties hereto.
SECTION 5.      Severability . Any provisions of this Amendment which are prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction.
SECTION 6.      Transaction Document . This Amendment shall be a Transaction Document for purposes of the Receivables Financing Agreement.
SECTION 7.      Counterparts . This Amendment may be executed in any number of counterparts, each of which when so executed shall be deemed to be an original and all of which when taken together shall constitute one and the same agreement. Delivery of an executed counterpart hereof by facsimile or other electronic means shall be equally effective as delivery of an originally executed counterpart.
SECTION 8.      GOVERNING LAW AND JURISDICTION .
(a)      THIS AMENDMENT, INCLUDING THE RIGHTS AND DUTIES OF THE PARTIES HERETO, SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK (INCLUDING SECTIONS 5-1401 AND

2



5-1402 OF THE GENERAL OBLIGATIONS LAW OF THE STATE OF NEW YORK, BUT WITHOUT REGARD TO ANY OTHER CONFLICTS OF LAW PROVISIONS THEREOF).
(b)      EACH PARTY HERETO HEREBY IRREVOCABLY SUBMITS TO (I) WITH RESPECT TO THE BORROWER AND THE SERVICER, THE EXCLUSIVE JURISDICTION, AND (II) WITH RESPECT TO EACH OF THE OTHER PARTIES HERETO, THE NON-EXCLUSIVE JURISDICTION, IN EACH CASE, OF ANY NEW YORK STATE OR FEDERAL COURT SITTING IN NEW YORK CITY, NEW YORK IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS AMENDMENT, AND EACH PARTY HERETO HEREBY IRREVOCABLY AGREES THAT ALL CLAIMS IN RESPECT OF SUCH ACTION OR PROCEEDING (I) IF BROUGHT BY THE BORROWER, THE SERVICER OR ANY AFFILIATE THEREOF, SHALL BE HEARD AND DETERMINED, AND (II) IF BROUGHT BY ANY OTHER PARTY TO THIS AMENDMENT, MAY BE HEARD AND DETERMINED, IN EACH CASE, IN SUCH NEW YORK STATE COURT OR, TO THE EXTENT PERMITTED BY LAW, IN SUCH FEDERAL COURT. NOTHING IN THIS SECTION 8 SHALL AFFECT THE RIGHT OF THE ADMINISTRATIVE AGENT OR ANY OTHER CREDIT PARTY TO BRING ANY ACTION OR PROCEEDING AGAINST THE BORROWER OR THE SERVICER OR ANY OF THEIR RESPECTIVE PROPERTY IN THE COURTS OF OTHER JURISDICTIONS. EACH OF THE BORROWER AND THE SERVICER HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT IT MAY EFFECTIVELY DO SO, THE DEFENSE OF AN INCONVENIENT FORUM TO THE MAINTENANCE OF SUCH ACTION OR PROCEEDING. THE PARTIES HERETO AGREE THAT A FINAL JUDGMENT IN ANY SUCH ACTION OR PROCEEDING SHALL BE CONCLUSIVE AND MAY BE ENFORCED IN OTHER JURISDICTIONS BY SUIT ON THE JUDGMENT OR IN ANY OTHER MANNER PROVIDED BY LAW.
SECTION 9.      Section Headings . The various headings of this Amendment are included for convenience only and shall not affect the meaning or interpretation of this Amendment, the Receivables Financing Agreement or any provision hereof or thereof.
[SIGNATURE PAGES FOLLOW]


3



IN WITNESS WHEREOF, the parties hereto have executed this Amendment by their duly authorized officers as of the date first above written.

 
SYNEOS HEALTH RECEIVABLES LLC  
 
By
:/s/ Thomas E. Zajkowski     
Name: Thomas E. Zajkowski
Title: President
 
 
 
 
 


 
INC RESEARCH, LLC,
as the Servicer  

 
By:
/s/ Jason Meggs     
Name: Jason Meggs
Title: Chief Financial Officer
 
 
 
 
 
 
 
 

S-1




 
PNC BANK, NATIONAL ASSOCIATION,
as Administrative Agent
 

 
By:
/s/ Christopher Blaney     
Name: Christopher Blaney
Title: Senior Vice President



 
 
 
 
 
PNC BANK, NATIONAL ASSOCIATION,
as a Lender
 

 
By:
/s/ Christopher Blaney     
Name: Christopher Blaney
Title: Senior Vice President

 
 
 
 
 
 
 
 
 
 
 
 
 


S-2



EXHIBIT A
(attached)



EXHIBIT A to THIRD AMENDMENT, dated as of October 25, 2018 CONFORMED COPY INCLUDES FIRST AMENDMENT, dated as of August 1, 2018 SECOND AMENDMENT, dated as of August 29, 2018 EXECUTION VERSION RECEIVABLES FINANCING AGREEMENT Dated as of June 29, 2018 by and among SYNEOS HEALTH RECEIVABLES LLC, as Borrower, THE PERSONS FROM TIME TO TIME PARTY HERETO, as Lenders, PNC BANK, NATIONAL ASSOCIATION, as Administrative Agent, INC RESEARCH, LLC, as initial Servicer, and PNC CAPITAL MARKETS LLC, as Structuring Agent 730302054 18569090


 
notes, note purchase, acceptance or credit facility, or other similar instruments or facilities, (iii) reimbursement obligations (contingent or otherwise) under any letter of credit, (iv) any other transaction (including production payments (excluding royalties), installment purchase agreements, forward sale or purchase agreements, capitalized leases and conditional sales agreements) having the commercial effect of a borrowing of money entered into by such Person to finance its operations or capital requirements (but not including accounts payable incurred in the ordinary course of such Person’s business payable on terms customary in the trade), (v) all net obligations of such Person in respect of interest rate or currency hedges or (vi) any Guaranty of any such Debt. “Deemed Collections” has the meaning set forth in Section 4.01(d). “Default Ratio” means the ratio (expressed as a percentage and rounded to the nearest 1/100 of 1%, with 5/1000th of 1% rounded upward) computed as of the last day of each Fiscal Month by dividing: (a) the aggregate Outstanding Balance of all Pool Receivables that became Defaulted Receivables during such Fiscal Month, by (b) the aggregate initial Outstanding Balance of all Pool Receivables (other than Unbilled Receivables) generated by the Originators during the month that is six (6) Fiscal Months (or if the Third Amendment Commencement Date, if any, has occurred, eight (8) Fiscal Months), before such Fiscal Month. “Defaulted Receivable” means a Receivable, without duplication: (a) as to which any payment, or part thereof, remains unpaid for 151 days or more (or if the Third Amendment Commencement Date, if any, has occurred, 211 days or more) after the original due date for such Receivable; (b) as to which an Insolvency Proceeding shall have occurred with respect to the Obligor thereof or any other Person obligated thereon or owning any Related Security with respect thereto; (c) that has been written off the applicable Originator’s or the Borrower’s books as uncollectible; or (d) that, consistent with the Credit and Collection Policy, should be written off the applicable Originator’s or the Borrower’s books as uncollectible; provided, however, that in each case above such amount shall be calculated without giving effect to any netting of credits that have not been matched to a particular Receivable for the purposes of aged trial balance reporting. “Defaulting Lender” means any Lender that (a) has failed, within two (2) Business Days of the date required to be funded or paid, to (i) fund any portion of its Loans or (ii) pay over to any Credit Party any other amount required to be paid by it hereunder, unless, in the case of clause (i) above, such Lender notifies the Administrative Agent in writing that such failure is the result of such Lender’s good faith determination that a condition precedent to funding (specifically identified and including the particular default, if any) has not been satisfied, (b) has notified the Borrower or any Credit Party in writing, or has made a public statement to the effect, that it does not intend or expect to comply with any of its funding obligations under this 9 730302054 18569090


 
Agreement (unless such writing or public statement indicates that such position is based on such Lender’s good faith determination that a condition precedent (specifically identified and including the particular default, if any) to funding a Loan under this Agreement cannot be satisfied) or generally under other agreements in which it commits to extend credit, (c) has failed, within three (3) Business Days after request by a Credit Party, acting in good faith, to provide a certification in writing from an authorized officer of such Lender that it will comply with its obligations (and is financially able to meet such obligations) to fund prospective Loans under this Agreement, provided that such Lender shall cease to be a Defaulting Lender pursuant to this clause (c) upon such Credit Party’s receipt of such certification in form and substance satisfactory to it and the Administrative Agent, or (d) has become the subject of an Insolvency Proceeding. “Delinquency Ratio” means the ratio (expressed as a percentage and rounded to the nearest 1/100 of 1%, with 5/1000th of 1% rounded upward) computed as of the last day of each Fiscal Month by dividing: (a) the aggregate Outstanding Balance of all Pool Receivables that were Delinquent Receivables on such day, by (b) the aggregate Outstanding Balance of all Pool Receivables on such day. “Delinquent Receivable” means a Receivable as to which any payment, or part thereof, remains unpaid for 91 days or more from the original due date for such payment; provided, however, that such amount shall be calculated without giving effect to any netting of credits that have not been matched to a particular Receivable for the purposes of aged trial balance reporting. “Dilution Horizon Ratio” means, for any Fiscal Month, the ratio (expressed as a percentage and rounded to the nearest 1/100th of 1%, with 5/1000th of 1% rounded upward) computed as of the last day of such Fiscal Month by dividing: (a) the aggregate initial Outstanding Balance of all Pool Receivables (other than Unbilled Receivables) generated by the Originators during such Fiscal Month, by (b) the sum of (x) the Net Receivables Pool Balance as of the last day of such Fiscal Month plus (y) the aggregate Outstanding Balance as of the last day of such Fiscal Month of all Receivables and portions of Receivables that do not constitute Eligible Receivables on such date solely due to the failure to satisfy clause (r) and/or clause (w) of the definition of “Eligible Receivable”. Within thirty (30) days of the completion and the receipt by the Administrative Agent of the results of any annual audit or field exam of the Receivables and the servicing and origination practices of the Servicer and the Originators, the numerator of the Dilution Horizon Ratio may be adjusted, after consultation with the Borrower, by the Administrative Agent upon not less than five (5) Business Days notice to the Borrower to reflect such number of Fiscal Months as the Administrative Agent reasonably believes best reflects the business practices of the Servicer and the Originators and the actual amount of dilution and Deemed Collections that occur with respect to Pool Receivables based on the weighted average dilution lag calculation completed as part of such audit or field exam. “Dilution Ratio” means, for any Fiscal Month, the ratio (expressed as a percentage and rounded to the nearest 1/100th of 1%, with 5/1000th of 1% rounded upward), computed as of the last day of each Fiscal Month by dividing: (i) the aggregate amount of Deemed Collections during such Fiscal Month (other than any Deemed Collections with respect to any Receivables that were both (x) generated by an Originator during such Fiscal Month and (y) written off the applicable Originator’s or the Borrower’s books as uncollectible during such Fiscal Month), by 10 730302054 18569090


 
“Lock-Box” means each locked postal box with respect to which a Collection Account Bank has executed an Account Control Agreement pursuant to which it has been granted exclusive access for the purpose of retrieving and processing payments made on the Receivables and which is listed on Schedule II (as such schedule may be modified from time to time in connection with the addition or removal of any Lock-Box in accordance with the terms hereof). “Loss Horizon Ratio” means the ratio (expressed as a percentage and rounded to the nearest 1/100 of 1%, with 5/1000th of 1% rounded upward) computed as of the last day of each Fiscal Month by dividing: (a) the sum of (x) the aggregate initial Outstanding Balance of all Pool Receivables (other than Unbilled Receivables) generated by the Originators during the six (6) most recent Fiscal Months plus (y) 65% of the aggregate initial Outstanding Balance of all Pool Receivables (other than Unbilled Receivables) generated by the Originators during the eighth most recent Fiscal Month; by (b) the sum of (x) the Net Receivables Pool Balance as of such date plus (y) the aggregate Outstanding Balance as of such date of all Receivables and portions of Receivables that do not constitute Eligible Receivables on such date solely due to the failure to satisfy clause (r) and/or clause (w) of the definition of “Eligible Receivable”. “Loss Reserve Percentage” means, at any time of determination, the product (expressed as a percentage and rounded to the nearest 1/100th of 1%, with 5/1000th of 1% rounded upward) of (a) the Stress Factor, multiplied by (b) the highest average of the Default Ratios for any three (3) consecutive Fiscal Months during the twelve (12) most recent Fiscal Months, multiplied by (c) the Loss Horizon Ratio. “Management Investors” means the officers, directors, managers, employees and members of management of Parent, any Parent Company and/or any subsidiary of Parent. “Majority Lenders” means Lenders representing more than 50% of the aggregate Commitments of all Lenders (or, if the Commitments have been terminated, Lenders representing more than 50% of the aggregate outstanding Capital held by all the Lenders). “Material Adverse Effect” means relative to any Person (provided that if no particular Person is specified, “Material Adverse Effect” shall be deemed to be relative to the Performance Guarantor, the Servicer and the Originators, in the aggregate) with respect to any event or circumstance, a material adverse effect on any of the following: (a) the assets, operations, business or financial condition of such Person or, if no Person is specified, of the Servicer, the Performance Guarantor and the Originators taken as a whole; (b) the ability of such Person, or if no Person is specified, of the Servicer, the Performance Guarantor and any Originators, taken as a whole, to perform its or their obligations under this Agreement or any other Transaction Document to which it is or they are a party; 22 730302054 18569090


 
“Subsidiary” means, as to any Person, a corporation, partnership, limited liability company or other entity of which shares of stock of each class or other interests having ordinary voting power (other than stock or other interests having such power only by reason of the happening of a contingency) to elect a majority of the Board of Directors or other managers of such entity are at the time owned, or management of which is otherwise controlled: (a) by such Person, (b) by one or more Subsidiaries of such Person or (c) by such Person and one or more Subsidiaries of such Person. “Syneos Party” means the Borrower, the Servicer, the Performance Guarantor and each Originator. “Taxes” means any and all present or future taxes, levies, imposts, duties, deductions, charges, withholdings (including backup withholding), assessments, fees or other charges imposed by any Governmental Authority and all interest, penalties, additions to tax and any similar liabilities with respect thereto. “Termination Date” means the earliest to occur of (a) the Scheduled Termination Date, (b) the date on which the “Termination Date” is declared or deemed to have occurred under Section 10.01, (c) the occurrence of a Purchase and Sale Termination Event under the Purchase and Sale Agreement, (d) the date selected by the Borrower on which all Commitments have been reduced to zero pursuant to Section 2.02(e) or (e) the date (if any) on which the Borrower, the Servicer or any Originator delivers to the Administrative Agent a written notice that the Borrower is unable to pay the “Purchase Price” (as defined in the Purchase and Sale Agreement) for Receivables and Related Rights pursuant to Section 3.2 of the Purchase and Sale Agreement. “Third Amendment Closing Date” means October 25, 2018. “Third Amendment Commencement Date” means the date elected by the Borrower as the “Third Amendment Commencement Date” in a written notice provided by the Borrower (or the Servicer on its behalf) to the Administrative Agent; provided, that such date may not occur more than 180 days following the Third Amendment Closing Date and any election following such date shall be null and void; provided, further, that neither the Borrower nor the Servicer on its behalf shall provide any notice of the election of the “Third Amendment Commencement Date” until such time as the Borrower (or the Servicer on its behalf) has provided such historical Receivables performance data as may be reasonably requested by the Administrative Agent on or prior to the Third Amendment Closing Date. “THL” means Thomas H. Lee Partners, L.P. and its Affiliates. “Threshold Amount” means $150,000,000. “Total Reserves” means, at any time of determination, an amount equal to the product of (i) the sum of: (a) the Yield Reserve Percentage, plus (b) the greater of (I) the sum of the Concentration Reserve Percentage, plus the Minimum Dilution Reserve Percentage and (II) the sum of the Loss Reserve Percentage, plus the Dilution Reserve Percentage, times (ii) the Net Receivables Pool Balance at such time. 30 730302054 18569090


 



Exhibit 31.1
CERTIFICATION PURSUANT TO SECTION 302 OF
THE SARBANES-OXLEY ACT OF 2002
I, Alistair Macdonald, certify that:
1. I have reviewed this Quarterly Report on Form 10-Q of Syneos Health, Inc. (the “registrant”);
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.
Date: November 5, 2018
 
 
/s/ Alistair Macdonald
Alistair Macdonald
Chief Executive Officer
(Principal Executive Officer)





Exhibit 31.2
CERTIFICATION PURSUANT TO SECTION 302 OF
THE SARBANES-OXLEY ACT OF 2002
I, Jason Meggs, certify that:
1. I have reviewed this Quarterly Report on Form 10-Q of Syneos Health, Inc. (the “registrant”);
2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
(a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
(b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.
Date: November 5, 2018
 
 
/s/ Jason Meggs
Jason Meggs
Chief Financial Officer
(Principal Financial Officer)





Exhibit 32.1
CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO SECTION 906
OF THE SARBANES-OXLEY ACT OF 2002
In accordance with 18 U.S.C. 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, I, Alistair Macdonald, Chief Executive Officer of Syneos Health, Inc. (the “registrant”), do hereby certify, that to the best of my knowledge:
1. The registrant's Quarterly Report on Form 10-Q for the period ended September 30, 2018 (the “Report”), to which this Certification is attached as Exhibit 32.1, fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and
2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.


Date: November 5, 2018
 
 
/s/ Alistair Macdonald
Alistair Macdonald
Chief Executive Officer
(Principal Executive Officer)

This certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and shall not be deemed “filed” by the registrant for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and shall not be incorporated by reference into any filing of the registrant under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, whether made before or after the date of the Report, irrespective of any general incorporation language contained in such filing.
A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.






Exhibit 32.2
CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO SECTION 906
OF THE SARBANES-OXLEY ACT OF 2002
In accordance with 18 U.S.C. 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, I, Jason Meggs, Chief Financial Officer of Syneos Health, Inc. (the “registrant”), do hereby certify, that to the best of my knowledge:
1. The registrant's Quarterly Report on Form 10-Q for the period ended September 30, 2018 (the “Report”), to which this Certification is attached as Exhibit 32.2, fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and
2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.
 
Date: November 5, 2018
 
 
/s/ Jason Meggs
Jason Meggs
Chief Financial Officer
(Principal Financial Officer)

This certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and shall not be deemed “filed” by the registrant for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and shall not be incorporated by reference into any filing of the registrant under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, whether made before or after the date of the Report, irrespective of any general incorporation language contained in such filing.
A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.