They'll pay for us to come out but are rarely willing to spend enough money for us to fully solve their problems. This isn't necessarily out of greed -- a lot of these places run on such small profit margins that they simply can't afford to have us completely eradicate an infestation. The trick is doing just enough to beat the health inspector, which in some cases requires nothing more than getting a receipt showing that you've paid to have some pest control work done. I've had restaurants simply offer me $50 for a bogus receipt (which I, of course, never accepted) just to keep the health inspector at bay.
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And things do get bad. The worst I saw was a Chinese restaurant where plates were stacked in a sink with five or six roaches sitting between each plate. Another time I walked into a place and saw an unidentified black grunge accumulated in the corners. I thought it was compacted dirt, so I started to talk with the owners about how cleaning stuff like that up would help with their infestation problem. However, as soon as I touched the grunge, it turned into a sea of roaches and scurried away. They had been clustered so tightly together that they looked like a single patch of grime. So yeah. If cleanliness is your thing, eat at Chipotle.