the demand for the company 's it solutions business , primarily in our healthcare vertical market in north america improved in 2018 as spending increased along with the improving economy . additionally , the demand for our it staffing and other services from certain of our large staffing clients increased during 2018. the company primarily operates in one industry segment , providing it services to its clients . these services include it solutions and it and other staffing . with it solutions services , we generally take responsibility for the deliverables on a project and the services may include high-end consulting . when providing it and other staffing services , we typically supply personnel to our clients who then , in turn , take their direction from the client 's managers . the company at times provides administrative or warehouse employees to clients to supplement the it staffing resources we place at those clients . it solutions and it and other staffing revenue as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_9_th 17 the company promotes a majority of its services through five vertical market focus areas : t echnology service p roviders , m anufacturing , h ealthcare ( which includes services provided to healthcare providers , health insurers ( payer s ) , and life sciences companies ) , f inancial s ervices , and e nergy . the remainder of ctg 's revenue is derived from general markets . ctg 's revenue by vertical market as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_10_th the it services industry is extremely competitive and characterized by continuous changes in client requirements and improvements in technologies . our competition varies significantly by geographic region , as well as by the type of service provided . many of our competitors are larger than ctg , and have greater financial , technical , sales , and marketing resources . in addition , the company frequently competes with a client 's own internal it staff . our industry is being impacted by the growing use of lower-cost offshore delivery capabilities ( primarily india and other parts of asia ) . there can be no assurance that we will be able to continue to compete successfully with existing or future competitors or that future competition will not have a material adverse effect on our results of operations and financial condition . revenue recognition the company recognizes revenue when control of the promised good or service is transferred to customers , in an amount that reflects the consideration the company expects to be entitled to in exchange for those goods or services . for time-and-material contracts , revenue is recognized as hours are incurred and costs are expended . for contracts with progress billing schedules , primarily monthly , revenue is recognized as services are rendered to the customer . revenue for fixed-price contracts is recognized over time using an input-based approach . over time revenue recognition best portrays the company 's performance in transferring control of the goods or services to the customer . on most fixed price contracts , revenue recognition is supported through contractual clauses that require the customer to pay for work performed to date , including cost plus a reasonable profit margin , for goods or services that have no alternative use to the company . on certain contracts , revenue recognition is supported through contractual clauses that indicate the customer controls the asset , or work in process , as the company creates or enhances the asset . on a given project , actual salary and indirect labor costs incurred are measured and compared with the total estimate of costs of such items at the completion of the project . revenue is recognized based upon the percentage-of-completion calculation of total incurred costs to total estimated costs . the company infrequently works on fixed-price projects that include significant amounts of material or other non-labor related costs that could distort the percent complete within a percentage-of-completion calculation . the company 's estimate of the total labor costs it expects to incur over the term of the contract is based on the nature of the project and our experience on similar projects , and includes management judgments and estimates that affect the amount of revenue recognized on fixed-price contracts in any accounting period . losses on fixed-price projects are recorded when identified . the company 's revenue from contracts accounted for under time-and-material , progress billing , and percentage-of-completion methods as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_11_th 18 results of operations the table below sets forth percentage information calculated as a percentage of consolidated revenue as reported on the company 's consolidated statements of operations as included in item 8 , “ financial statements and supplementary data ” in this report . replace_table_token_12_th 2018 as compared with 2017 the company recorded revenue in 2018 and 2017 as follows : replace_table_token_13_th reimbursable expenses billed to clients and included in revenue totaled $ 3.2 million and $ 3.3 million in 2018 and 2017 , respectively . the revenue increase in north america in 2018 as compared with 2017 was primarily due to a significant increase in demand for the company 's it solutions business , primarily in our healthcare vertical market , and a modest increase in demand for our it staffing business , primarily in our technology services provider vertical market . the revenue increase in europe is primarily due to strong demand for the company 's services in the european markets we serve , and the acquisition of soft company on february 15 , 2018 , which has an annual revenue of approximately $ 30 million . story_separator_special_tag no other client accounted for more than 10 % of the company 's revenue in 2017 or 2016. direct costs , defined as costs for billable staff including billable out-of-pocket expenses , were 81.4 % and 81.8 % of consolidated revenue in 2017 and 2016 , respectively . in the 2017 third quarter , the company recorded a significant increase in fringe benefit costs primarily consisting of medical expense . the increase in medical expense , which totaled approximately $ 1.0 million in direct costs , was due to much higher utilization of the company 's self-insured medical plan during the year . the company also recorded $ 0.4 million of severance charges in the 2017 second quarter . in the 2016 second quarter , the company 's european operations recorded a payroll tax credit totaling approximately $ 0.7 million which reduced direct costs in 2016. the credited amounts returned certain costs incurred from 2011 to 2014 , and the company does not anticipate a significant credit in the future . when considering these items , direct costs as a percentage of revenue in 2017 decreased as compared with 2016. this decrease was in part due to the significant reduction in it staffing revenue . these services are provided to the company 's largest it staffing clients , which have much higher direct costs as a percentage of revenue as compared with the company 's it solutions clients . selling , general and administrative ( sg & a ) expenses were 17.3 % of revenue in 2017 as compared with 17.0 % of revenue in 2016. the increase in sg & a expenses as a percentage of revenue in 2017 as compared with 2016 is primarily due to costs incurred by our operating units as the company continues to make investments in sales , recruiting and 22 delivery resources in order to focus on the company 's long-t erm growth , and the loss of operating leverage from a decrease in revenue . additionally , severance incurred for the resignation of three former executives totaled $ 0.4 million and $ 1.5 million in 2017 and 2016 , respectively . during the 2016 first quarter , the company determined that a goodwill impairment indicator existed which required an interim impairment analysis . as a result of the analysis , the company determined the implied fair value of its goodwill balance was below the carrying value . accordingly , the company recorded a non-tax deductible goodwill impairment charge of $ 21.5 million to reduce the value of its goodwill balance to the implied fair value . additionally , during the 2016 third quarter , the company determined that another goodwill impairment indicator existed which required a second interim impairment analysis . as a result of the analysis , the company determined the implied fair value of its goodwill balance was again below the carrying value . accordingly , the company recorded a non-tax deductible goodwill impairment charge of $ 15.8 million to reduce the value of its goodwill balance to the implied fair value , which reduced the company 's goodwill balance to $ 0.0. the significant increase in operating income in 2017 was due to the goodwill impairment charges taken in the 2016 first and third quarters totaling $ 37.3 million . operating income ( loss ) was 1.3 % of revenue in 2017 as compared with ( 10.3 ) % of revenue in 2016. operating loss from north american operations was reduced by $ 1.2 million of unexpected costs associated with the company 's self-insurance medical plan , and $ 0.8 million for severance charges for former executives , or $ 2.0 million in total , and was $ 0.1 million in 2017 compared with $ 35.7 million in 2016. operating income from our european operations was $ 4.0 million in 2017 compared with $ 2.4 million in 2016. the increase in operating income in 2017 compared with 2016 is primarily due to an increase in revenue due to strong demand for the company 's services in the european markets we serve . the 2016 results in europe were reduced by a goodwill impairment charge of approximately $ 1.7 million , offset by a payroll tax credit of $ 0.7 million recorded in the 2016 second quarter . other income ( expense ) was 0.1 % of revenue in 2017 and ( 0.1 ) % of revenue in 2016. in 2017 , the company recorded a non-taxable life insurance gain of approximately $ 0.4 million as one of its former executives passed away in the 2017 fourth quarter . the company 's effective tax rate ( etr ) is calculated based upon the full year 's operating results and various tax related items . the etr in 2017 was 80.1 % , while the 2016 etr was ( 3.3 ) % . the etr was higher than the normal range in 2017 primarily due to the effects of the tax cuts & jobs act which resulted in the company reducing its u.s. deferred tax assets by $ 1.7 million and the adoption of asu 2016-09 , “ improvements to employee share-based payment accounting , ” which required the company to record approximately $ 0.3 million in 2017 of additional tax expense for shortfalls that would previously have been recorded to capital in excess of par value on the company 's consolidated balance sheet . this additional tax expense was partially offset by tax benefits for the work opportunity tax credit ( wotc ) and research and development tax credit ( r & d ) . the etr was lower than the normal range in 2016 primarily due to the non-deductible goodwill impairment charges totaling $ 37.3 million in the 2016 first and third quarters , and also due to the extension of the work opportunity tax credit ( wotc ) and the research and development tax credit ( r & d ) which were renewed by the u.s. federal government

financial condition and liquidity cash provided by ( used in ) operating activities was $ ( 0.3 ) million , $ 9.2 million , and $ 2.4 million in 2018 , 2017 , and 2016 , respectively . in 2018 , net loss was $ ( 2.8 ) million , while other non-cash adjustments , primarily consisting of depreciation expense , equity-based compensation , deferred income taxes , deferred compensation , and non-taxable life insurance gain totaled $ 6.3 million . in 2017 and 2016 , net income ( loss ) was $ 0.8 million and $ ( 34.6 ) million , respectively , while the corresponding non-cash adjustments netted to $ 4.5 million and $ 40.3 million , respectively . accounts receivable balances increased $ 8.7 million in 2018 as compared with 2017 , decreased $ 5.2 million in 2017 as compared with 2016 , and increased $ 0.7 million in 2016 as compared with 2015. the increase in the accounts receivable balance in 2018 resulted from an increase in revenue of 24.8 % in the 2018 fourth quarter as compared with the 2017 fourth quarter . despite the increase in 2018 fourth quarter revenue , the company experienced a decrease in days sales outstanding ( dso ) due an acceleration of cash collection from several customers . dso is calculated by dividing accounts receivable obtained from the consolidated balance sheet by average daily revenue for the fourth quarter of the respective year . dso was 82 days at december 31 , 2018 as compared with dso at december 31 , 2017 of 86 days . dso was 86 days at december 31 , 2017 as compared with dso at december 31 , 2016 of 85 days . 24 the cash surrender value of life insurance policies increased $ 1.4 million in 2018 , increased $ 0.8 million in 2017 , and increased $ 0.6 million in 2016 . the increase in each of the years were due to normal appreciation of the existing cash surrender value of the outstanding policies at each respective point in time .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```financial condition and liquidity cash provided by ( used in ) operating activities was $ ( 0.3 ) million , $ 9.2 million , and $ 2.4 million in 2018 , 2017 , and 2016 , respectively . in 2018 , net loss was $ ( 2.8 ) million , while other non-cash adjustments , primarily consisting of depreciation expense , equity-based compensation , deferred income taxes , deferred compensation , and non-taxable life insurance gain totaled $ 6.3 million . in 2017 and 2016 , net income ( loss ) was $ 0.8 million and $ ( 34.6 ) million , respectively , while the corresponding non-cash adjustments netted to $ 4.5 million and $ 40.3 million , respectively . accounts receivable balances increased $ 8.7 million in 2018 as compared with 2017 , decreased $ 5.2 million in 2017 as compared with 2016 , and increased $ 0.7 million in 2016 as compared with 2015. the increase in the accounts receivable balance in 2018 resulted from an increase in revenue of 24.8 % in the 2018 fourth quarter as compared with the 2017 fourth quarter . despite the increase in 2018 fourth quarter revenue , the company experienced a decrease in days sales outstanding ( dso ) due an acceleration of cash collection from several customers . dso is calculated by dividing accounts receivable obtained from the consolidated balance sheet by average daily revenue for the fourth quarter of the respective year . dso was 82 days at december 31 , 2018 as compared with dso at december 31 , 2017 of 86 days . dso was 86 days at december 31 , 2017 as compared with dso at december 31 , 2016 of 85 days . 24 the cash surrender value of life insurance policies increased $ 1.4 million in 2018 , increased $ 0.8 million in 2017 , and increased $ 0.6 million in 2016 . the increase in each of the years were due to normal appreciation of the existing cash surrender value of the outstanding policies at each respective point in time .
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 Suspicious Activity Report : the demand for the company 's it solutions business , primarily in our healthcare vertical market in north america improved in 2018 as spending increased along with the improving economy . additionally , the demand for our it staffing and other services from certain of our large staffing clients increased during 2018. the company primarily operates in one industry segment , providing it services to its clients . these services include it solutions and it and other staffing . with it solutions services , we generally take responsibility for the deliverables on a project and the services may include high-end consulting . when providing it and other staffing services , we typically supply personnel to our clients who then , in turn , take their direction from the client 's managers . the company at times provides administrative or warehouse employees to clients to supplement the it staffing resources we place at those clients . it solutions and it and other staffing revenue as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_9_th 17 the company promotes a majority of its services through five vertical market focus areas : t echnology service p roviders , m anufacturing , h ealthcare ( which includes services provided to healthcare providers , health insurers ( payer s ) , and life sciences companies ) , f inancial s ervices , and e nergy . the remainder of ctg 's revenue is derived from general markets . ctg 's revenue by vertical market as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_10_th the it services industry is extremely competitive and characterized by continuous changes in client requirements and improvements in technologies . our competition varies significantly by geographic region , as well as by the type of service provided . many of our competitors are larger than ctg , and have greater financial , technical , sales , and marketing resources . in addition , the company frequently competes with a client 's own internal it staff . our industry is being impacted by the growing use of lower-cost offshore delivery capabilities ( primarily india and other parts of asia ) . there can be no assurance that we will be able to continue to compete successfully with existing or future competitors or that future competition will not have a material adverse effect on our results of operations and financial condition . revenue recognition the company recognizes revenue when control of the promised good or service is transferred to customers , in an amount that reflects the consideration the company expects to be entitled to in exchange for those goods or services . for time-and-material contracts , revenue is recognized as hours are incurred and costs are expended . for contracts with progress billing schedules , primarily monthly , revenue is recognized as services are rendered to the customer . revenue for fixed-price contracts is recognized over time using an input-based approach . over time revenue recognition best portrays the company 's performance in transferring control of the goods or services to the customer . on most fixed price contracts , revenue recognition is supported through contractual clauses that require the customer to pay for work performed to date , including cost plus a reasonable profit margin , for goods or services that have no alternative use to the company . on certain contracts , revenue recognition is supported through contractual clauses that indicate the customer controls the asset , or work in process , as the company creates or enhances the asset . on a given project , actual salary and indirect labor costs incurred are measured and compared with the total estimate of costs of such items at the completion of the project . revenue is recognized based upon the percentage-of-completion calculation of total incurred costs to total estimated costs . the company infrequently works on fixed-price projects that include significant amounts of material or other non-labor related costs that could distort the percent complete within a percentage-of-completion calculation . the company 's estimate of the total labor costs it expects to incur over the term of the contract is based on the nature of the project and our experience on similar projects , and includes management judgments and estimates that affect the amount of revenue recognized on fixed-price contracts in any accounting period . losses on fixed-price projects are recorded when identified . the company 's revenue from contracts accounted for under time-and-material , progress billing , and percentage-of-completion methods as a percentage of consolidated revenue for the three years ended december 31 , 2018 , 2017 , and 2016 is as follows : replace_table_token_11_th 18 results of operations the table below sets forth percentage information calculated as a percentage of consolidated revenue as reported on the company 's consolidated statements of operations as included in item 8 , “ financial statements and supplementary data ” in this report . replace_table_token_12_th 2018 as compared with 2017 the company recorded revenue in 2018 and 2017 as follows : replace_table_token_13_th reimbursable expenses billed to clients and included in revenue totaled $ 3.2 million and $ 3.3 million in 2018 and 2017 , respectively . the revenue increase in north america in 2018 as compared with 2017 was primarily due to a significant increase in demand for the company 's it solutions business , primarily in our healthcare vertical market , and a modest increase in demand for our it staffing business , primarily in our technology services provider vertical market . the revenue increase in europe is primarily due to strong demand for the company 's services in the european markets we serve , and the acquisition of soft company on february 15 , 2018 , which has an annual revenue of approximately $ 30 million . story_separator_special_tag no other client accounted for more than 10 % of the company 's revenue in 2017 or 2016. direct costs , defined as costs for billable staff including billable out-of-pocket expenses , were 81.4 % and 81.8 % of consolidated revenue in 2017 and 2016 , respectively . in the 2017 third quarter , the company recorded a significant increase in fringe benefit costs primarily consisting of medical expense . the increase in medical expense , which totaled approximately $ 1.0 million in direct costs , was due to much higher utilization of the company 's self-insured medical plan during the year . the company also recorded $ 0.4 million of severance charges in the 2017 second quarter . in the 2016 second quarter , the company 's european operations recorded a payroll tax credit totaling approximately $ 0.7 million which reduced direct costs in 2016. the credited amounts returned certain costs incurred from 2011 to 2014 , and the company does not anticipate a significant credit in the future . when considering these items , direct costs as a percentage of revenue in 2017 decreased as compared with 2016. this decrease was in part due to the significant reduction in it staffing revenue . these services are provided to the company 's largest it staffing clients , which have much higher direct costs as a percentage of revenue as compared with the company 's it solutions clients . selling , general and administrative ( sg & a ) expenses were 17.3 % of revenue in 2017 as compared with 17.0 % of revenue in 2016. the increase in sg & a expenses as a percentage of revenue in 2017 as compared with 2016 is primarily due to costs incurred by our operating units as the company continues to make investments in sales , recruiting and 22 delivery resources in order to focus on the company 's long-t erm growth , and the loss of operating leverage from a decrease in revenue . additionally , severance incurred for the resignation of three former executives totaled $ 0.4 million and $ 1.5 million in 2017 and 2016 , respectively . during the 2016 first quarter , the company determined that a goodwill impairment indicator existed which required an interim impairment analysis . as a result of the analysis , the company determined the implied fair value of its goodwill balance was below the carrying value . accordingly , the company recorded a non-tax deductible goodwill impairment charge of $ 21.5 million to reduce the value of its goodwill balance to the implied fair value . additionally , during the 2016 third quarter , the company determined that another goodwill impairment indicator existed which required a second interim impairment analysis . as a result of the analysis , the company determined the implied fair value of its goodwill balance was again below the carrying value . accordingly , the company recorded a non-tax deductible goodwill impairment charge of $ 15.8 million to reduce the value of its goodwill balance to the implied fair value , which reduced the company 's goodwill balance to $ 0.0. the significant increase in operating income in 2017 was due to the goodwill impairment charges taken in the 2016 first and third quarters totaling $ 37.3 million . operating income ( loss ) was 1.3 % of revenue in 2017 as compared with ( 10.3 ) % of revenue in 2016. operating loss from north american operations was reduced by $ 1.2 million of unexpected costs associated with the company 's self-insurance medical plan , and $ 0.8 million for severance charges for former executives , or $ 2.0 million in total , and was $ 0.1 million in 2017 compared with $ 35.7 million in 2016. operating income from our european operations was $ 4.0 million in 2017 compared with $ 2.4 million in 2016. the increase in operating income in 2017 compared with 2016 is primarily due to an increase in revenue due to strong demand for the company 's services in the european markets we serve . the 2016 results in europe were reduced by a goodwill impairment charge of approximately $ 1.7 million , offset by a payroll tax credit of $ 0.7 million recorded in the 2016 second quarter . other income ( expense ) was 0.1 % of revenue in 2017 and ( 0.1 ) % of revenue in 2016. in 2017 , the company recorded a non-taxable life insurance gain of approximately $ 0.4 million as one of its former executives passed away in the 2017 fourth quarter . the company 's effective tax rate ( etr ) is calculated based upon the full year 's operating results and various tax related items . the etr in 2017 was 80.1 % , while the 2016 etr was ( 3.3 ) % . the etr was higher than the normal range in 2017 primarily due to the effects of the tax cuts & jobs act which resulted in the company reducing its u.s. deferred tax assets by $ 1.7 million and the adoption of asu 2016-09 , “ improvements to employee share-based payment accounting , ” which required the company to record approximately $ 0.3 million in 2017 of additional tax expense for shortfalls that would previously have been recorded to capital in excess of par value on the company 's consolidated balance sheet . this additional tax expense was partially offset by tax benefits for the work opportunity tax credit ( wotc ) and research and development tax credit ( r & d ) . the etr was lower than the normal range in 2016 primarily due to the non-deductible goodwill impairment charges totaling $ 37.3 million in the 2016 first and third quarters , and also due to the extension of the work opportunity tax credit ( wotc ) and the research and development tax credit ( r & d ) which were renewed by the u.s. federal government

