For ORM, my initial client was through Reddit. Since then, a few were from BHW contacts, and others were based on referrals from the first guy.
For local SEO, I go high quality or don't go at all, so my plan is to do the following:
1) Build up a site in their sector that ranks higher than their own.
2) Send ten businesses in that sector personalized letters a la 7878, showing them what I can do, how their results stack up, a market analysis, and let them know that I sent similar letters to nine of their competitors, and I'm only going to be working with one of them.
3) Charge them $2,500+ per month for full service local SEO.
4) Repeat with a new sector in the same local market.
Fingers crossed on that one.