I am sure that elmer sent the BFS for review only after he was certain that the reviews will be confirmations of the study, I do'nt forsee major changes it will be limited to costs variences which can be accomodated and resolved instantly.

Although I'm sure he's seen the whole thing once or twice by now, if he was doing the internal review now/at the same time they sent it to Merit - that means that he obviously didn't look at it AS IN DEPTH to see changes that may need to be made. Or, not changes that NEED to be made, but if were made would help. Elmer may have looked at something and been like "Yup, that works or checks out" but that doesn't mean someone else looking at it can't be like "This would be a better way to do it and would save $X more".