Medpace Holdings, Inc.

Good day, ladies and gentlemen, and welcome to the MedPace First Quarter 2026 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speaker's remarks, there will be a question-and-answer session. If you'd like to ask a question, please press star 1-1 on your phone. If your question has been answered and you'd like to remove yourself from the queue, simply press star 1-1 again. As a reminder, this call is being recorded. I would now like to introduce your host for today's conference call, Lauren Morris, MedPace's Director of Investor Relations. You may begin.

Good morning, and thank you for joining MedPace's first quarter 2026 earnings conference call. Also on the call today is our CEO, August Trendle, our President, Jesse Geiger, and our CFO, Kevin Brady. Before we begin, I would like to remind you that our remarks and responses to your questions during this teleconference may include forward-looking statements within the meaning of the Private Security Litigation Reform Act of 1995. These statements involve inherent assumptions with known and unknown risks and uncertainties, as well as other important factors that could cause actual results to differ materially from our current expectations. These factors are discussed in our Form 10-K and other filings with the SEC. to update forward-looking statements, even if estimates change. Accordingly, you should not rely on any of today's forward-looking statements as representing our views as of any date after today. During this call, we will also be referring to certain non-GAAP financial measures. These non-GAAP measures are not superior to or a replacement for the comparable GAAP measures, but we believe these measures help investors gain a more complete understanding of results. A reconciliation of such non-gap financial measures to the most directly comparable gap measures is available in our earnings press release and earnings call presentation slides provided in connection with today's call. The slides are available in the investor relations section of our website at investors.medface.com. With that, I would now like to turn the call over to August Rundle.

Good day, everyone. Before reviewing Q1 results, I would like to acknowledge that this will be our last earnings call with Jesse Geiger, our president. I would like to thank Jesse for his 18 and a half years of service. Thank you, Jesse. Quarter 1 of 2026 saw cancellations rise again, with backlog cancels reaching their highest point in over a year. Net bookings were below the level seen in Q4, but well above those in Q1 2025, with a net book-to-bill ratio of 0.88. RFPs were down in the quarter sequentially and year over year. Initial reward notifications and win rate were strong. We continue to view the quality of opportunity flow as good. While there is nothing we can do to alter our cancellation rate, we are focused on expanding our pipeline of opportunities and have implemented a number of initiatives to improve our win rate. Jesse will now comment on Q1.