In Design-Bid-Build, procurement is a discrete phase that begins only after the design is substantially complete: the owner advertises the finished construction documents, contractors submit competitive lump-sum prices, and the contract is awarded — typically to the lowest responsive, responsible bidder. This article covers the mechanics of that procurement path: how the bid package is assembled, how the solicitation is run, how bids are evaluated and awarded, and the healthcare-specific wrinkles that shape each step.

The defining feature is sequence and separation: design is "done" (or believed to be) before a single price is solicited, and the contractor selected to build had no hand in producing the documents. That separation is the source of both DBB's price transparency and its change-order exposure — and it makes the integrity of the bid package the single most important determinant of a clean procurement.

Procurement is a standalone phase, not a parallel activity

Unlike progressive or collaborative models (CMAR, Design-Build, IPD) where the builder is engaged early and pricing evolves with the design, DBB procurement is a clean handoff:

1. Design completes — the A/E produces 100% construction documents (drawings + project manual/specifications) stamped and sealed by licensed professionals.
2. Owner advertises — the completed package is issued to the market through a public or invited solicitation.
3. Contractors price — bidders take off quantities, solicit subcontractor and supplier quotes, and assemble a single lump-sum (stipulated-sum) bid.
4. Owner awards — bids are opened, evaluated for responsiveness and responsibility, and a contract is executed with the winning bidder.

Because pricing happens against finished documents, the owner gets a hard number before committing to construction — DBB's core value proposition. The cost is that the contractor's first opportunity to scrutinize the design comes during bidding, not during design, so any errors, omissions, or constructability problems surface as change orders or RFIs after award rather than as collaborative fixes before it.

Public vs. private procurement sets the rules

Whether the owner is a public or private entity fundamentally changes how procurement is run.

Public owners (state and county hospital authorities, public university medical centers, VA and other federal facilities, municipal health departments) are bound by procurement statutes and regulations:

• Competitive sealed bidding is usually mandatory for construction. Bids are submitted sealed, opened publicly at an advertised time and place, read aloud, and tabulated in the open.
• Lowest responsive, responsible bidder is the default award standard — price drives the decision, with limited room for qualitative judgment.
• Advertising requirements dictate minimum public-notice periods and channels.
• Prevailing-wage rules (federal Davis-Bacon Act on federally funded work; state "little Davis-Bacon" statutes) often apply, raising labor cost and adding certified-payroll compliance.
• Bonding and small/disadvantaged-business participation goals are frequently codified.
• Federal projects add their own layers — the Federal Acquisition Regulation (FAR) for direct federal work, or Uniform Guidance (2 CFR 200) procurement standards for federally funded grants.

Private owners (most nonprofit and investor-owned health systems) have far more latitude. They commonly use invited (closed) bidding from a pre-qualified short list, may weigh qualifications alongside price, can negotiate after bids are in, and are not bound to take the low number. Private DBB procurement therefore looks more like a managed bid event than a statutory ritual — but the same package-integrity and evaluation discipline still applies.

The bid package is the contract-to-be