Dan Rosenburg of Ioriwase directed this question to Robert Deom, Project Manager

I was wondering if you could email me one or two examples of the reasons why the tendering process was delayed for the project….The answer to that question on the info sheets you sent me was that it was "to allow resolution of outstanding issues, some of which are regulatory, administrative or technical in nature," which kind of leaves a lot to the imagination…

In order to provide more detail regarding the nature of the project delay, the general reasons are:
Estimates for a few project elements increased. The scope of renovation increased as the result of facility-driven requests for improvement and in response to evolution in certain codes and standards. The estimate for increased facility costs resulting from operating during construction, was refined. The refinement resulted in a considerable increase. In order to balance the project budget, the facility was required to make several concessions in the design. This optimization process was completed in February, 2014. It should be noted that the design concessions did not affect the essential project program.
The other significant time factor relates to the negotiation, between the Mohawk Council of Kahnawake and the government of Quebec, of a global agreement on labour. The agreement is meant to govern situations where a significant mix of workers from Kahnawake and the outside would be working on a project on the territory. As the hospital project foresees such a labour situation, the Quebec government desired the project be governed by the labour agreement. The agreement contains a section pertaining specifically to the hospital project, which opens the road for the construction tender to be called. KMHC received authorization from the Ministry of Health to proceed to tender on August 28.